# MIREVA WELLNESS

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

## Provider details

- **NPI number:** 1326831249
- **Authorized official:** FRANCES AMBER TYSOB (OWNER)
- **Authorized official phone:** (281) 595-0949

## Contact information

- **Practice address:** 17300 EL CAMINO REAL STE 110D, HOUSTON, TX 77058-2715
- **Practice address phone:** (281) 595-0949
- **Practice address fax:** (888) 331-2054
- **Mailing address:** 1000 MAIN ST STE 2300, HOUSTON, TX 77002-6353
- **Mailing address phone:** (281) 595-0949
- **Mailing address fax:** (888) 331-2054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 05/23/2025
- **Last updated:** 06/21/2025