# TEXAS FEDERAL WELLNESS CENTER OF LAREDO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Texas Federal Wellness Center of Laredo
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972098630
- **Authorized official:** CANDICE ZIMMER (CREDENTIALING)
- **Authorized official phone:** (512) 800-3659

## Contact information

- **Practice address:** 8607 MCPHERSON RD STE 101, LAREDO, TX 78045-6383
- **Practice address phone:** (956) 568-3583
- **Mailing address:** 8607 MCPHERSON RD STE 101, LAREDO, TX 78045-6383
- **Mailing address phone:** (956) 568-3583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 06/26/2018
- **Last updated:** 06/26/2018