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General NPI Number Information
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NPI Number | 1386013803
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Entity Type | Organization
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Legal Business Name | TEN13 GROUP, LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 9601 KATY FWY SUITE 430
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City | HOUSTON
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State | TX
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Zip | 77024-1342
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Country | US
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Telephone | 713-533-8786
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Fax | 713-573-2798
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Provider Business Mailing Address
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Address Line | 9601 KATY FWY SUITE 430
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City | HOUSTON
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State | TX
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Zip | 77024-1342
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Country | US
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Telephone | 713-533-8786
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Fax | 713-573-2798
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/OWNER
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Name | DR. SUSANNA PARK
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Credential | D.C.
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Telephone | 713-533-8786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 12198
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License Number State | TX
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