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Organization
WEIGHT LOSS CLINIC OF COLLEGE STATION, LLC
Active
Organization
WEIGHT LOSS CLINIC OF COLLEGE STATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JOEL OREN (MANAGING MEMBER)
(817) 271-4154
Entity
Organization
Contact information
Practice address
1105 UNIVERSITY DR E, SUITE 100, COLLEGE STATION, TX 77840-2183
(979) 393-0369
(979) 446-0755
Mailing address
2050 SHADY OAKS DR, SOUTHLAKE, TX 76092-3510
(817) 271-4154
(817) 796-1595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669792321
NPI
TX
01
—
1740380923
NPI
TX
01
—
1790890259
NPI
TX
01
—
1851710347
NPI
TX
Enumeration date
10/29/2015
Last updated
05/20/2016
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