Healthcare Provider Details

I. General information

NPI: 1457504698
Provider Name (Legal Business Name): FRIENDSWOOD DOCTORS OF CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 S FRIENDSWOOD DR
FRIENDSWOOD TX
77546-4855
US

IV. Provider business mailing address

903 S FRIENDSWOOD DR
FRIENDSWOOD TX
77546-4855
US

V. Phone/Fax

Practice location:
  • Phone: 281-996-7600
  • Fax: 281-996-6988
Mailing address:
  • Phone: 281-996-7600
  • Fax: 281-996-6988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number6279
License Number StateTX

VIII. Authorized Official

Name: DR. JESSE THOMAS COATS
Title or Position: CEO
Credential: D.C.
Phone: 281-996-7600