Healthcare Provider Details

I. General information

NPI: 1699433854
Provider Name (Legal Business Name): BUBBYCOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16103 W LITTLE YORK RD STE E
HOUSTON TX
77084-6867
US

IV. Provider business mailing address

7814 BLACK GAP DR
CYPRESS TX
77433-1959
US

V. Phone/Fax

Practice location:
  • Phone: 281-855-9858
  • Fax:
Mailing address:
  • Phone: 832-665-5943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KAREN R CRESWELL
Title or Position: PRESIDENT
Credential:
Phone: 832-665-5943