MEDICARE: PACIFIC HEALTH CLINIC, P.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

General Provider Information

NPI Number	:	1093972721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC HEALTH CLINIC, P.C.

Provider Business Mailing Address
First Line	:	8866 GULF FWY
Second Line	:	SUTIE 301
City	:	HOUSTON
State	:	TX
Zip	:	77017-6514
Country	:	US
Telephone Number	:	713-944-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	8866 GULF FWY
Second Line	:	SUTIE 301
City	:	HOUSTON
State	:	TX
Zip	:	77017-6514
Country	:	US
Telephone Number	:	713-944-6300
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTOR
Name	:	MANDY Q. NGO
Credential	:	D.C.
Telephone Number	:	713-944-6300

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	05/20/2008

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