MEDICARE: PHOENIXINJURYCENTERINC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1255723979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIXINJURYCENTERINC

Provider Business Mailing Address
First Line	:	6420 RICHMOND AVE STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5921
Country	:	US
Telephone Number	:	832-242-6402
Fax Number	:	832-242-6564

Provider Business Practice Location Address
First Line	:	6420 RICHMOND AVE STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5921
Country	:	US
Telephone Number	:	832-242-6402
Fax Number	:	832-242-6564

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. GHODRATT BORAZJANIAN
Credential	:	DC
Telephone Number	:	832-498-3000

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	03/04/2015

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Directions to “PHOENIXINJURYCENTERINC ” Practice Location

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