Healthcare Provider Details

I. General information

NPI: 1306023627
Provider Name (Legal Business Name): MIJE WOLFF & ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4622 MITTLESTEDT RD
HOUSTON TX
77069-2104
US

IV. Provider business mailing address

4622 MITTLESTEDT RD
HOUSTON TX
77069-2104
US

V. Phone/Fax

Practice location:
  • Phone: 281-587-0334
  • Fax: 281-587-0351
Mailing address:
  • Phone: 281-587-0334
  • Fax: 281-587-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4624
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5058
License Number StateTX

VIII. Authorized Official

Name: DR. MICHAEL JOHN WOLFF
Title or Position: DOCTOR
Credential: D.C.
Phone: 281-587-0334