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General NPI Number Information
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NPI Number | 1255852588
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Entity Type | Organization
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Legal Business Name | MARTIN CHIROPRACTIC HOUSE CALLS, LLC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 2800 BROADWAY ST STE C129
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City | PEARLAND
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State | TX
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Zip | 77581-9502
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Country | US
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Telephone | 832-895-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 BROADWAY ST STE C129
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City | PEARLAND
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State | TX
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Zip | 77581-9502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | LAUREN MARTIN
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Credential | DC
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Telephone | 832-895-1114
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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 | 12350
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License Number State | TX
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