Healthcare Provider Details

I. General information

NPI: 1598941031
Provider Name (Legal Business Name): MED-ACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12018 ECHO CANYON DR
TOMBALL TX
77377-7866
US

IV. Provider business mailing address

12018 ECHO CANYON DR
TOMBALL TX
77377-7866
US

V. Phone/Fax

Practice location:
  • Phone: 832-368-5833
  • Fax: 832-565-1653
Mailing address:
  • Phone: 832-368-5833
  • Fax: 832-565-1653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HILTON
Title or Position: OWNER
Credential:
Phone: 832-368-5833