MEDICARE: SPINE TIME CHIROPRACTIC, LLC

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	:	1285318766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINE TIME CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	2800 KIRBY DR APT B707
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1491
Country	:	US
Telephone Number	:	714-468-9622
Fax Number	:

Provider Business Practice Location Address
First Line	:	7707 FANNIN ST STE 160
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1926
Country	:	US
Telephone Number	:	832-934-7766
Fax Number	:	832-321-7240

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. NATHAN THUAN NGUYEN
Credential	:	DC
Telephone Number	:	714-468-9622

Provider Enumeration Date	:	06/14/2023
Last Update Date	:	01/18/2026

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