Organization
WELLNESS RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XIAOLI RONG (MANAGER)
(817) 247-1509
Entity
Organization
Contact information
Practice address
2515 INWOOD RD STE 107, DALLAS, TX 75235-7400
(817) 247-1509
Mailing address
PO BOX 161789, FORT WORTH, TX 76161-1789
(817) 247-1509
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
803085831
IRS
TX
Enumeration date
09/12/2019
Last updated
09/12/2019
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