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General NPI Number Information
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NPI Number | 1851694236
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Entity Type | Organization
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Legal Business Name | SAN JACINTO CHIROPRACTIC WELLNESS CENTER
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 106 MASSEY TOMPKINS RD
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City | BAYTOWN
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State | TX
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Zip | 77521-4302
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Country | US
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Telephone | 281-422-2004
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Fax | 821-422-0465
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Provider Business Mailing Address
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Address Line | 106 MASSEY TOMPKINS RD
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City | BAYTOWN
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State | TX
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Zip | 77521-4302
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Country | US
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Telephone | 281-422-2004
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Fax | 821-422-0465
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD E LINDBERG
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Credential | D.C.
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Telephone | 281-422-2004
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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 | TX4598
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License Number State | TX
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