Healthcare Provider Details

I. General information

NPI: 1043256696
Provider Name (Legal Business Name): ADRAINE LYNN MOSELY D.C,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5912 SPENCER HWY
PASADENA TX
77505-1602
US

IV. Provider business mailing address

5912 SPENCER HWY
PASADENA TX
77505-1602
US

V. Phone/Fax

Practice location:
  • Phone: 281-487-1501
  • Fax: 281-998-0558
Mailing address:
  • Phone: 281-487-1501
  • Fax: 281-998-0558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9812
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: