# PUR WELLNESS AND AESTHETICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midtowne Wellness and Aesthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710643382
- **Authorized official:** JACQUELINE REBECCA MILES NP (OWNER)
- **Authorized official phone:** (702) 493-5720

## Contact information

- **Practice address:** 529 GEORGE HOPPER RD., SUITE A, MIDLOTHAIN, TX 76065
- **Practice address phone:** (469) 231-4596
- **Mailing address:** 529 GEORGE HOPPER RD., SUITE A, MIDLOTHAIN, TX 76065
- **Mailing address phone:** (469) 231-4596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2021
- **Last updated:** 11/09/2021