# DOCTORS WEIGHT LOSS CENTER & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063852069
- **Authorized official:** MRS. ADYS MIRABAL VICE PRESIDENT (MANAGING PARNER)
- **Authorized official phone:** (512) 782-2084

## Contact information

- **Practice address:** 11215 S INTERSTATE 35, SUITE 114, AUSTIN, TX 78747-1863
- **Practice address phone:** (512) 782-2084
- **Practice address fax:** (512) 782-2088
- **Mailing address:** 11215 S INTERSTATE 35, SUITE 114, AUSTIN, TX 78747-1863
- **Mailing address phone:** (512) 782-2084
- **Mailing address fax:** (512) 782-2088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | 736533 | TX | Yes |

## Other

- **Enumeration date:** 07/05/2013
- **Last updated:** 07/05/2013