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General NPI Number Information
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NPI Number | 1699248419
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Entity Type | Organization
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Legal Business Name | 101 R LLC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 9000 SOUTHWEST FWY STE 204
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City | HOUSTON
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State | TX
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Zip | 77074-1520
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Country | US
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Telephone | 832-962-7966
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Fax | 832-962-7991
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Provider Business Mailing Address
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Address Line | 9000 SOUTHWEST FWY STE 204
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City | HOUSTON
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State | TX
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Zip | 77074-1520
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Country | US
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Telephone | 832-962-7966
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Fax | 832-962-7991
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Authorized Official
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Title or Position | CEO
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Name | MR. ANTHONY R SUEING SR.
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Credential |
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Telephone | 281-989-9419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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