Healthcare Provider Details

I. General information

NPI: 1033433123
Provider Name (Legal Business Name): SHAWN TAHER DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12155 JONES RD SUITE A
HOUSTON TX
77070-5281
US

IV. Provider business mailing address

12155 JONES RD SUITE A
HOUSTON TX
77070-5281
US

V. Phone/Fax

Practice location:
  • Phone: 281-890-5599
  • Fax: 281-890-7067
Mailing address:
  • Phone: 281-890-5599
  • Fax: 281-890-7067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10024
License Number StateTX

VIII. Authorized Official

Name: DR. SHAWN TAHER
Title or Position: BUSINESS OWNER
Credential: D.C
Phone: 28189055996