Healthcare Provider Details

I. General information

NPI: 1346479110
Provider Name (Legal Business Name): S & S THERAPY LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4295 SAN FELIPE ST STE 230
HOUSTON TX
77027-2915
US

IV. Provider business mailing address

4295 SAN FELIPE ST STE 230
HOUSTON TX
77027-2915
US

V. Phone/Fax

Practice location:
  • Phone: 713-629-9200
  • Fax: 713-513-5048
Mailing address:
  • Phone: 713-629-9200
  • Fax: 713-513-5048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number11592
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number9740
License Number StateTX

VIII. Authorized Official

Name: DR. DANIEL W. DEWALCH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 713-629-9200