Healthcare Provider Details

I. General information

NPI: 1639317761
Provider Name (Legal Business Name): GLOBKE FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 FM 517 RD E STE B
DICKINSON TX
77539-8623
US

IV. Provider business mailing address

2320 FM 517 RD E STE B
DICKINSON TX
77539-8623
US

V. Phone/Fax

Practice location:
  • Phone: 281-337-6007
  • Fax: 281-337-0013
Mailing address:
  • Phone: 281-337-6007
  • Fax: 281-337-0013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9742
License Number StateTX

VIII. Authorized Official

Name: DR. LELAND RICHARD GLOBKE
Title or Position: PRESIDENT
Credential: DC
Phone: 281-337-6007