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General NPI Number Information
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NPI Number | 1205431236
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Entity Type | Organization
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Legal Business Name | 100 PERCENT CHIROPRACTIC LIVINGOOD TX PLLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 30129 ROCK CREEK DR STE 1000
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City | KINGWOOD
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State | TX
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Zip | 77339-2869
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Country | US
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Telephone | 346-616-5154
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 LOUETTA RD STE B200
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City | HOUSTON
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State | TX
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Zip | 77070-2160
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Country | US
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Telephone | 832-843-6632
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Fax | 832-514-6836
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Authorized Official
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Title or Position | FRANCHISEE
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Name | DAVID YAW
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Credential |
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Telephone | 720-409-6006
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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 |
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License Number State |
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