Healthcare Provider Details
I. General information
NPI: 1649852336
Provider Name (Legal Business Name): BAYBROOK CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2021
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14200 GULF FWY STE 110
HOUSTON TX
77034-5361
US
IV. Provider business mailing address
14200 GULF FWY STE 110
HOUSTON TX
77034-5361
US
V. Phone/Fax
- Phone: 832-667-8132
- Fax: 281-664-5899
- Phone: 832-667-8132
- Fax: 281-664-5899
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MAZEN
ZAIBAK
Title or Position: CEO
Credential:
Phone: 346-342-1818