1437334182 NPI number — PACE CHIROPRACTIC & PHYSICAL THERAPY INC

Table of content: (NPI 1437334182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437334182 NPI number — PACE CHIROPRACTIC & PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PACE CHIROPRACTIC & PHYSICAL THERAPY INC
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:
PACE PHYSICAL THERAPY SERVICES
Provider Other Organization Name Type Code:
5
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:
1437334182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4106 UNDERWOOD ST
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:
77025-1720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-274-2321
Provider Business Mailing Address Fax Number:
346-353-9864

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4106 UNDERWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77025-1720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-274-2321
Provider Business Practice Location Address Fax Number:
346-353-9864
Provider Enumeration Date:
12/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PACE
Authorized Official First Name:
MARY
Authorized Official Middle Name:
BETH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
832-274-2321

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X , with the licence number: 9190 , 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)

  • Identifier: 0008KD . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 181900501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 861610 . This is a "BCBS CHIROPRACTIC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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