# THE ICON FOR BALANCED HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ICON WELLNESS CENTER AND MEDICAL SPA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730335977
- **Authorized official:** DR. JOHN ROBERT JOHNSTON MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (281) 724-0190

## Contact information

- **Practice address:** 250 BLOSSOM ST, SUITE 100, WEBSTER, TX 77598-4204
- **Practice address phone:** (281) 724-0190
- **Practice address fax:** (281) 724-0191
- **Mailing address:** 250 BLOSSOM ST, SUITE 100, WEBSTER, TX 77598-4204
- **Mailing address phone:** (281) 724-0190
- **Mailing address fax:** (281) 724-0191

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2008
- **Last updated:** 08/08/2008