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General NPI Number Information
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NPI Number | 1235213950
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Entity Type | Organization
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Legal Business Name | I-10 EAST CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 4151 SOUTHWEST FWY STE 750
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City | HOUSTON
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State | TX
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Zip | 77027-7320
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Country | US
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Telephone | 713-455-8599
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Fax | 713-552-9006
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Provider Business Mailing Address
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Address Line | 4151 SOUTHWEST FWY STE 750
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City | HOUSTON
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State | TX
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Zip | 77027-7320
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Country | US
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Telephone | 713-455-8599
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Fax | 713-552-9006
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. TODD L BEAR
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Credential | DC
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Telephone | 713-552-9080
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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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