Healthcare Provider Details

I. General information

NPI: 1235210329
Provider Name (Legal Business Name): JESSE SCHNERINGER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 HOSTETTER ROAD
NEW WAVERLY TX
77358-4070
US

IV. Provider business mailing address

403 HOSTETTER ROAD
NEW WAVERLY TX
77358-4070
US

V. Phone/Fax

Practice location:
  • Phone: 713-203-6984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8177
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: