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General NPI Number Information
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NPI Number | 1245509066
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Entity Type | Organization
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Legal Business Name | UNITED CHIROPRACTIC
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 1120 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77506-4724
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Country | US
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Telephone | 713-472-1444
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Fax | 713-472-8713
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Provider Business Mailing Address
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Address Line | 1120 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77506-4724
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Country | US
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Telephone | 713-472-1444
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Fax | 713-472-8713
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. DINO DEMETRIOU
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Credential | DC
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Telephone | 713-472-1444
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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 | 5325
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License Number State | TX
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