Organization
EVOLVE WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN E DIAZ (LPC/OWNER)
(210) 414-5398
Entity
Organization
Contact information
Practice address
4081 DE ZAVALA RD STE 201, SHAVANO PARK, TX 78249-2082
(210) 971-4380
Mailing address
4081 DE ZAVALA RD STE 201, SHAVANO PARK, TX 78249-2082
(210) 971-4380
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2022
Last updated
06/01/2022
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