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Organization
KETAMINE WELLNESS CENTERS HOUSTON
Active
Organization
KETAMINE WELLNESS CENTERS HOUSTON
Active
Parent organization
KETAMINE WELLNESS CENTERS ARIZONA LLC
Other names
Ketamine Wellness Centers
Organization subpart
Yes
Provider details
NPI number
Legal business name
KETAMINE WELLNESS CENTERS ARIZONA LLC
Authorized official
MS. ANITA JERGER (EXECUTIVE ASSISTANT)
(855) 538-9355
Entity
Organization
Contact information
Practice address
12807 HAYNES RD UNIT 1, HOUSTON, TX 77066-1124
(855) 538-9355
(844) 538-9355
Mailing address
12807 HAYNES RD UNIT 1, HOUSTON, TX 77066-1124
(855) 538-9355
(844) 538-9355
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/16/2020
Last updated
08/17/2022
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