Healthcare Provider Details

I. General information

NPI: 1093908683
Provider Name (Legal Business Name): FAAST SPORTS REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6666 HARWIN DR STE 500
HOUSTON TX
77036-2235
US

IV. Provider business mailing address

6666 HARWIN DR STE 500
HOUSTON TX
77036-2235
US

V. Phone/Fax

Practice location:
  • Phone: 713-334-3278
  • Fax: 713-400-9550
Mailing address:
  • Phone: 713-334-3278
  • Fax: 713-400-9550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10117
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number10117
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number10117
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number10117
License Number StateTX

VIII. Authorized Official

Name: DR. DAVID CHRISTOPHER MORRISSEY
Title or Position: OWNER
Credential: DC
Phone: 832-372-1999