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NPI Code Detail

MEDICARE: LANCE LYLE MCCLINTOCK

MEDICARE:   LANCE LYLE MCCLINTOCK
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
1111N00000XChiropractor11905TX

General Provider Information

NPI Number : 1275818437
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE LYLE MCCLINTOCK
Provider Business Mailing Address
First Line : 3100 TIMMONS LN STE 135
Second Line :
City : HOUSTON
State : TX
Zip : 77027-5965
Country : US
Telephone Number : 713-355-5343
Fax Number : 713-355-6999
Provider Business Practice Location Address
First Line : 3100 TIMMONS LN STE 135
Second Line :
City : HOUSTON
State : TX
Zip : 77027-5965
Country : US
Telephone Number : 713-355-5343
Fax Number : 713-355-6999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2011
Last Update Date : 03/12/2012

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Directions to “ LANCE LYLE MCCLINTOCK ” Practice Location

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