Healthcare Provider Details

I. General information

NPI: 1194904441
Provider Name (Legal Business Name): ROBERT ANTHONY RAKOWSKI DC, CCN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 BAY AREA BLVD
HOUSTON TX
77058-2631
US

IV. Provider business mailing address

449 BAY AREA BLVD
HOUSTON TX
77058-2631
US

V. Phone/Fax

Practice location:
  • Phone: 281-286-6040
  • Fax: 281-286-4120
Mailing address:
  • Phone: 281-286-6040
  • Fax: 281-286-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: