Organization
PROSPERITY LIFE STYLE CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANIA KRISTINE LUCAS CPT/CN (OWNER)
(361) 355-5686
Entity
Organization
Contact information
Practice address
1601 SANTA MONICA ST., KINGSVILLE, TX 78363-3458
(361) 355-5686
Mailing address
1601 SANTA MONICA ST., KINGSVILLE, TX 78363-3458
(361) 355-5686
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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