Organization
R2 WELL PRACTICE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTE VAN EEDEN (CEO)
(817) 571-6505
Entity
Organization
Contact information
Practice address
451 WESTPARK WAY STE 5, EULESS, TX 76040-3703
(817) 571-6505
Mailing address
451 WESTPARK WAY STE 5, EULESS, TX 76040-3703
(817) 571-6505
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
G0723
TX
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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