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General NPI Number Information
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NPI Number | 1629217971
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Entity Type | Organization
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Legal Business Name | BISSONNET WELLNESS CENTER
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 9819 BISSONNET ST STE S
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City | HOUSTON
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State | TX
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Zip | 77036-8227
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Country | US
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Telephone | 713-995-1200
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Fax | 713-995-1201
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Provider Business Mailing Address
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Address Line | 9819 BISSONNET ST STE S
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City | HOUSTON
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State | TX
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Zip | 77036-8227
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Country | US
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Telephone | 713-995-1200
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Fax | 713-995-1201
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. IYAD TARABEH
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Credential | PHARMD
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Telephone | 832-466-2596
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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 | F008422
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License Number State | TX
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