# MEDI WEIGHTLOSS

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

## Provider details

- **NPI number:** 1689116832
- **Authorized official:** IVY CASTILLO (MANAGER)
- **Authorized official phone:** (817) 375-0537

## Contact information

- **Practice address:** 4000 FIVE POINTS BLVD., SUITE 169, ARLINGTON, TX 76018
- **Practice address phone:** (817) 375-0537
- **Mailing address:** 4000 FIVE POINTS BLVD., SUITE 169, ARLINGTON, TX 76018
- **Mailing address phone:** (817) 375-0537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | AP131658 | TX | Yes |

## Other

- **Enumeration date:** 11/04/2016
- **Last updated:** 11/04/2016