Healthcare Provider Details

I. General information

NPI: 1235468463
Provider Name (Legal Business Name): SMART BODY CHIROPRACTIC & WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 04/22/2022
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 MANVEL RD
PEARLAND TX
77584-7537
US

IV. Provider business mailing address

2723 MANVEL RD
PEARLAND TX
77584-7537
US

V. Phone/Fax

Practice location:
  • Phone: 281-997-1333
  • Fax: 281-997-1335
Mailing address:
  • Phone: 281-997-1333
  • Fax: 281-997-1335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9773
License Number StateTX

VIII. Authorized Official

Name: DR. DENISE MARIE VARGO
Title or Position: CLINICAL DIRECTOR
Credential: D.C.
Phone: 281-997-1333