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General NPI Number Information
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NPI Number | 1679852974
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Entity Type | Organization
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Legal Business Name | KINGSLAND ADVANCED HEALTH & CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 6250 WESTPARK DR STE 319
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City | HOUSTON
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State | TX
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Zip | 77057-7381
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Country | US
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Telephone | 832-667-8952
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Fax | 832-667-8485
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Provider Business Mailing Address
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Address Line | 6250 WESTPARK DR STE 319
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City | HOUSTON
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State | TX
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Zip | 77057-7381
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Country | US
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Telephone | 832-667-8952
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Fax | 832-667-8485
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD CLYDE SAULS
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Credential |
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Telephone | 832-276-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | F009193
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License Number State | TX
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