Basic Information
| Provider Information | |||||||||
| NPI: | 1366802381 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEE BUSY WELLNESS CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10039 BISSONNET ST STE 250 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770367852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137712292 | ||||||||
| FaxNumber: | 7137712294 | ||||||||
| Practice Location | |||||||||
| Address1: | 10039 BISSONNET ST STE 250 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770367852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137712292 | ||||||||
| FaxNumber: | 7137712294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2016 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | MITCHELL | ||||||||
| AuthorizedOfficialFirstName: | NORMAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7137712292 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
ID Information
| ID | Type | State | Issuer | Description | 74-1953 | 01 | CMS CERTIFICATION | OTHER | 367305501 | 05 | TX | MEDICAID |