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Organization
SOUTHLAKE WEIGHT LOSS, LLC
Active
Organization
SOUTHLAKE WEIGHT LOSS, LLC
Active
Other names
Medi-Weightloss Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JOEL OREN (MANAGING MEMBER)
(817) 271-4154
Entity
Organization
Contact information
Practice address
601 E SOUTHLAKE BLVD, SUITE 200, SOUTHLAKE, TX 76092-6251
(817) 488-1956
(817) 488-8675
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
E4781
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043277221
NPI
TX
01
—
1215094933
NPI
TX
01
—
1376654988
NPI
TX
01
—
1558612325
NPI
TX
01
—
1740308923
NPI
TX
01
—
1871868232
NPI
TX
Enumeration date
12/29/2015
Last updated
12/29/2015
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