MEDICARE: ALTERNATIVE HEALTH CENTER OF THE WOODLANDS

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154955888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE HEALTH CENTER OF THE WOODLANDS

Provider Business Mailing Address
First Line	:	2829 TECHNOLOGY FOREST BLVD STE 250
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-3913
Country	:	US
Telephone Number	:	281-419-9104
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 TECHNOLOGY FOREST BLVD STE 250
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-3913
Country	:	US
Telephone Number	:	281-419-9104
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	MRS. SARA RILEY
Credential	:	CHIROPRACTOR
Telephone Number	:	405-420-3424

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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