Healthcare Provider Details

I. General information

NPI: 1417169194
Provider Name (Legal Business Name): VENESSA C BARTHOLOMEW DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16626 SEA LARK RD
HOUSTON TX
77062-5819
US

IV. Provider business mailing address

16626 SEA LARK RD
HOUSTON TX
77062-5819
US

V. Phone/Fax

Practice location:
  • Phone: 281-488-0111
  • Fax:
Mailing address:
  • Phone: 281-488-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11567
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: