Healthcare Provider Details

I. General information

NPI: 1992654792
Provider Name (Legal Business Name): DR. JEREMY ARDOIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19380 NORTH FWY STE 170
SPRING TX
77373-5310
US

IV. Provider business mailing address

9003 WATER POINT DR
BEACH CITY TX
77523-9807
US

V. Phone/Fax

Practice location:
  • Phone: 281-719-0461
  • Fax:
Mailing address:
  • Phone: 832-866-7499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16744
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: