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General NPI Number Information
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NPI Number | 1033522875
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Entity Type | Organization
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Legal Business Name | NASA CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 940 GEMINI ST STE 101
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City | HOUSTON
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State | TX
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Zip | 77058-2763
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Country | US
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Telephone | 281-486-1675
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Fax | 281-486-7677
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Provider Business Mailing Address
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Address Line | 415 NARCISSUS RD
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City | KEMAH
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State | TX
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Zip | 77565-2440
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Country | US
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Telephone | 832-693-0366
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Fax | 281-486-1677
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | WINSTON CASE RICKS
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Credential | D.C.
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Telephone | 281-486-1675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10954
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License Number State | TX
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