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General NPI Number Information
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NPI Number | 1598952038
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Entity Type | Organization
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Legal Business Name | GUAJARDO CLINIC PA
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 6901 CANAL ST
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City | HOUSTON
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State | TX
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Zip | 77011
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Country | US
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Telephone | 713-928-6255
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Fax | 713-928-6245
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Provider Business Mailing Address
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Address Line | 6901 CANAL ST
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City | HOUSTON
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State | TX
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Zip | 77011
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Country | US
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Telephone | 713-928-6255
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Fax | 713-928-6245
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Authorized Official
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Title or Position | OWNER
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Name | JOSE ROLANDO GUAJARDO
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Credential | DC
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Telephone | 713-928-6255
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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 | 8294
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License Number State | TX
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