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General NPI Number Information
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NPI Number | 1447502935
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Entity Type | Organization
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Legal Business Name | SE CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 6006 BELLAIRE BLVD STE 200
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City | HOUSTON
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State | TX
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Zip | 77081-5439
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Country | US
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Telephone | 713-667-5198
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Fax |
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Provider Business Mailing Address
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Address Line | 6006 BELLAIRE BLVD SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77081
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Country | US
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Telephone | 713-667-5198
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Fax |
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Authorized Official
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Title or Position | ALEXANDER GENSON
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Name | NELLY GENSON
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Credential | DC
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Telephone | 713-667-5190
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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 | 7848
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License Number State | TX
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