Organization
PUR WELLNESS AND AESTHETICS
Active
Other names
Midtowne Wellness and Aesthetics
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE REBECCA MILES NP (OWNER)
(702) 493-5720
Entity
Organization
Contact information
Practice address
529 GEORGE HOPPER RD., SUITE A, MIDLOTHAIN, TX 76065
(469) 231-4596
Mailing address
529 GEORGE HOPPER RD., SUITE A, MIDLOTHAIN, TX 76065
(469) 231-4596
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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