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Organization

KEN ADOLPH WELLNESS, LLC

Active
Other names
Illumma
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HOWARD KENNETH ADOLPH MD (FOUNDER/MEDICAL DIRECTOR)
(512) 750-1348
Entity
Organization

Contact information

Practice address
2911 MEDICAL ARTS ST STE 19A, AUSTIN, TX 78705-3329
(512) 686-5935
(737) 242-9997
Mailing address
2911 MEDICAL ARTS ST STE 19A, AUSTIN, TX 78705-3329
(512) 585-9594

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215901368
TX
Enumeration date
11/12/2020
Last updated
05/15/2025
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