MEDICARE: DR. LOURDES H LABRADA D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	10086	TX
2	111NS0005X	Sports Physician Chiropractor	10086	TX
3	111NR0400X	Rehabilitation Chiropractor	10086	TX

General Provider Information

NPI Number	:	1063447688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOURDES H LABRADA D.C.

Provider Business Mailing Address
First Line	:	4801 WOODWAY DR
Second Line	:	SUITE 369W
City	:	HOUSTON
State	:	TX
Zip	:	77056-1884
Country	:	US
Telephone Number	:	713-622-7060
Fax Number	:	713-622-7093

Provider Business Practice Location Address
First Line	:	4801 WOODWAY DR
Second Line	:	SUITE 369W
City	:	HOUSTON
State	:	TX
Zip	:	77056-1884
Country	:	US
Telephone Number	:	713-622-7060
Fax Number	:	713-622-7093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/01/2008

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