Healthcare Provider Details

I. General information

NPI: 1497116396
Provider Name (Legal Business Name): MVMT CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2016
Last Update Date: 04/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 W DALLAS ST
HOUSTON TX
77019-3807
US

IV. Provider business mailing address

937 W 23RD ST
HOUSTON TX
77008-1809
US

V. Phone/Fax

Practice location:
  • Phone: 832-723-2349
  • Fax:
Mailing address:
  • Phone: 832-723-2349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13160
License Number StateTX

VIII. Authorized Official

Name: DR. JOHN DAVID MASON
Title or Position: FOUNDER-CHIROPRACTOR
Credential: DC
Phone: 832-723-2349