Healthcare Provider Details

I. General information

NPI: 1558581793
Provider Name (Legal Business Name): KOALA LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N AKARD ST
DALLAS TX
75201-3303
US

IV. Provider business mailing address

PO BOX 890389
HOUSTON TX
77289-0389
US

V. Phone/Fax

Practice location:
  • Phone: 214-969-6999
  • Fax: 214-969-7090
Mailing address:
  • Phone: 281-286-8520
  • Fax: 281-286-2947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MARY DOYLE
Title or Position: OWNER
Credential:
Phone: 713-463-9111