# PRISTINE SERENITY MED SPA LLC

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

## Provider details

- **NPI number:** 1629721345
- **Authorized official:** BIANCA ROBINSON (OWNER)
- **Authorized official phone:** (713) 870-9738

## Contact information

- **Practice address:** 19121 W LAKE HOUSTON PKWY \# 1, HUMBLE, TX 77346-4825
- **Practice address phone:** (832) 819-1415
- **Mailing address:** 14802 BARTON GROVE LN, HUMBLE, TX 77396-4234
- **Mailing address phone:** (713) 870-9738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2022
- **Last updated:** 02/02/2022