Healthcare Provider Details

I. General information

NPI: 1174718852
Provider Name (Legal Business Name): SHAWN K TAHER D.C,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12155 JONES RD
HOUSTON TX
77070-5281
US

IV. Provider business mailing address

12155 JONES RD
HOUSTON TX
77070-5281
US

V. Phone/Fax

Practice location:
  • Phone: 281-890-5599
  • Fax: 281-890-7067
Mailing address:
  • Phone: 281-890-5599
  • Fax: 281-890-7067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number10024
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10024
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: