Healthcare Provider Details

I. General information

NPI: 1871606020
Provider Name (Legal Business Name): HOUSTON SPINE & REHABILITATION CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 COLLEGE PARK DR.
THE WOODLANDS TX
77384-4099
US

IV. Provider business mailing address

3101 COLLEGE PARK DR.
THE WOODLANDS TX
77384-4099
US

V. Phone/Fax

Practice location:
  • Phone: 281-362-0006
  • Fax: 281-362-0233
Mailing address:
  • Phone: 281-362-0006
  • Fax: 281-362-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC7094
License Number StateTX

VIII. Authorized Official

Name: MR. MARK C YEZAK
Title or Position: PRESIDENT
Credential: DC
Phone: 281-362-0006