MEDICARE: INTERVENTIONAL SPORTS AND WELLNESS ASSOCIATES PLLC

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	:	1306704937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERVENTIONAL SPORTS AND WELLNESS ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	9802 FM 1960 BYPASS RD W STE 205
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-3510
Country	:	US
Telephone Number	:	281-570-2961
Fax Number	:	281-570-6527

Provider Business Practice Location Address
First Line	:	9802 FM 1960 BYPASS RD W STE 205
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-3510
Country	:	US
Telephone Number	:	281-570-2961
Fax Number	:	281-570-6527

Authorized Official
Title or Position	:	OWNER
Name	:	OKEZIE NDUBISI OKEZIE
Credential	:	MD
Telephone Number	:	281-570-2961

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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