Organization
ELITE WELLNESS AND WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARRIE COOK (OWNER)
(817) 953-0940
Entity
Organization
Contact information
Practice address
100 W SOUTHLAKE BLVD, STE 180, SOUTHLAKE, TX 76092-6100
(817) 953-0940
Mailing address
100 W SOUTHLAKE BLVD, STE 180, SOUTHLAKE, TX 76092-6100
(817) 953-0940
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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