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General NPI Number Information
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NPI Number | 1124162060
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Entity Type | Organization
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Legal Business Name | FUQUA HEALTH & REHAB
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 11007A FUQUA ST
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City | HOUSTON
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State | TX
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Zip | 77089-2510
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Country | US
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Telephone | 713-943-7477
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Fax | 713-941-7518
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Provider Business Mailing Address
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Address Line | 11007A FUQUA ST
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City | HOUSTON
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State | TX
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Zip | 77089-2510
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Country | US
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Telephone | 713-943-7477
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Fax | 713-941-7518
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN T. MAI
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Credential | D.C.
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Telephone | 713-943-7477
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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 | DC8156
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License Number State | TX
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