=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952604548
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDALE CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2010
-----------------------------------------------------
Last Update Date | 12/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9100 SOUTHWEST FWY 225
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77074-1519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-771-1583
-----------------------------------------------------
Fax | 713-456-2954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9100 SOUTHWEST FWY 225
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77074-1519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-771-1583
-----------------------------------------------------
Fax | 713-456-2954
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. DUY BUI
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 713-771-1583
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | 11509
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 11509
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------