Healthcare Provider Details

I. General information

NPI: 1093927287
Provider Name (Legal Business Name): MARIE C BIELAMOWICZ-TYNAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIE C BIELAMOWICZ DC

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 WHITE OAK DR
HOUSTON TX
77007-2642
US

IV. Provider business mailing address

PO BOX 7527
HOUSTON TX
77270-7527
US

V. Phone/Fax

Practice location:
  • Phone: 713-861-6186
  • Fax: 713-861-6186
Mailing address:
  • Phone: 713-861-6186
  • Fax: 713-861-6186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC7969
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: