Organization
ADVANCED WELLNESS
Active
Organization
ADVANCED WELLNESS
Active
Parent organization
ADVWELLNESS, LLC
Other names
Advanced Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVWELLNESS, LLC
Authorized official
ROXANNE W. WHEELER (CREDENTIALING SPECIALIST)
(936) 579-3931
Entity
Organization
Contact information
Practice address
5605 OLD BULLARD RD STE B, TYLER, TX 75703
(903) 630-5595
(903) 630-5599
Mailing address
212 OLD GRANDE BLVD STE A200, TYLER, TX 75703-4204
(214) 327-3186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
06/01/2018
Last updated
09/17/2018
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