1013249556 NPI number — SPINETASTIK - THE FUTURE OF CHIROPRACTIC

Table of content: (NPI 1013249556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013249556 NPI number — SPINETASTIK - THE FUTURE OF CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPINETASTIK - THE FUTURE OF CHIROPRACTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013249556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14731 BELTERRAZA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77083-6760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-391-0269
Provider Business Mailing Address Fax Number:
281-469-7315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11211 KATY FWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77079-2106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-250-8425
Provider Business Practice Location Address Fax Number:
713-589-8844
Provider Enumeration Date:
02/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LUNA
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
713-391-0269

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  11271 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com