Healthcare Provider Details

I. General information

NPI: 1881945095
Provider Name (Legal Business Name): MARK S PALANDRO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SLOSSEN ST
WEBSTER TX
77598-5043
US

IV. Provider business mailing address

307 WOODCOMBE DR
HOUSTON TX
77062-2539
US

V. Phone/Fax

Practice location:
  • Phone: 281-948-8707
  • Fax: 713-559-0309
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12147
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: