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NPI Code Detail

MEDICARE: HALDEN P MAYNARD DC

MEDICARE:   HALDEN P MAYNARD  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor14336TX

General Provider Information

NPI Number : 1164192605
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALDEN P MAYNARD DC
Provider Business Mailing Address
First Line : 1803 W WHITE OAK TER STE A
Second Line :
City : CONROE
State : TX
Zip : 77304-3675
Country : US
Telephone Number : 936-253-5314
Fax Number : 936-253-1035
Provider Business Practice Location Address
First Line : 125 BLUE HERON DR STE B
Second Line :
City : MONTGOMERY
State : TX
Zip : 77316-3183
Country : US
Telephone Number : 936-582-0404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2021
Last Update Date : 05/14/2025

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Directions to “ HALDEN P MAYNARD DC” Practice Location

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