MEDICARE: MISSOURI CITY CHIROPRACTIC AND REHAB CLINIC

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	261Q00000X	Clinic/Center
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1255936621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSOURI CITY CHIROPRACTIC AND REHAB CLINIC

Provider Business Mailing Address
First Line	:	2755 TEXAS PKWY STE 102
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5114
Country	:	US
Telephone Number	:	832-430-7690
Fax Number	:	832-440-7693

Provider Business Practice Location Address
First Line	:	2755 TEXAS PKWY STE 102
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5114
Country	:	US
Telephone Number	:	832-430-7690
Fax Number	:	832-440-7693

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. KIVA L DAVIS X
Credential	:	DC
Telephone Number	:	832-440-7690

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	05/04/2022

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Directions to “MISSOURI CITY CHIROPRACTIC AND REHAB CLINIC ” Practice Location

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