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General NPI Number Information
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NPI Number | 1891196481
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Entity Type | Organization
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Legal Business Name | ELITE CHIRO GROUP LLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 1849 PEARLAND PKWY STE 107
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City | PEARLAND
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State | TX
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Zip | 77581-5343
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Country | US
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Telephone | 281-412-9642
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Fax | 832-327-5121
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Provider Business Mailing Address
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Address Line | 1849 PEARLAND PKWY STE 107
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City | PEARLAND
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State | TX
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Zip | 77581-5343
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Country | US
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Telephone | 281-412-9642
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Fax | 832-327-5121
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SHANE PAUL SIGG
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Credential | D.C.
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Telephone | 281-412-9642
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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 | 11987
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License Number State | TX
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