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General NPI Number Information
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NPI Number | 1245987262
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Entity Type | Organization
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Legal Business Name | SUPREME CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 10333 HARWIN DR STE 370
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City | HOUSTON
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State | TX
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Zip | 77036-1675
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Country | US
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Telephone | 713-636-2226
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Fax | 713-360-6964
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Provider Business Mailing Address
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Address Line | 10333 HARWIN DR STE 370
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City | HOUSTON
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State | TX
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Zip | 77036-1675
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Country | US
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Telephone | 713-636-2226
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Fax | 713-360-6964
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Authorized Official
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Title or Position | CCCA
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Name | ROFFIA MCWHORTER
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Credential |
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Telephone | 832-455-8638
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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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