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General NPI Number Information
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NPI Number | 1942821368
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Entity Type | Organization
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Legal Business Name | STARK CHIROPRACTIC & SPORTS, PLLC
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 8500 CYPRESSWOOD DR STE 207
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City | SPRING
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State | TX
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Zip | 77379-7105
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Country | US
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Telephone | 281-547-8930
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Fax | 281-547-8931
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Provider Business Mailing Address
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Address Line | 5625 FM 1960 RD W STE 400
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City | HOUSTON
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State | TX
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Zip | 77069-4211
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Country | US
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Telephone | 281-836-5908
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Fax | 281-836-5909
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. SHEA STARK
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Credential | DC, CCSP, ICSC, EMT
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Telephone | 281-547-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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