MEDICARE: MICHAEL C. WALTHER JR. D.C.

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	6924	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2237276	OTHER	TX	FIRST HEALTH
2	606673	OTHER	TX	BCBS
3	662634	OTHER	TX	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1326056698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL C. WALTHER JR. D.C.

Provider Business Mailing Address
First Line	:	7171 HIGHWAY 6 N STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2422
Country	:	US
Telephone Number	:	281-550-0650
Fax Number	:	281-815-3678

Provider Business Practice Location Address
First Line	:	7050 LAKEVIEW HAVEN DR
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77095-2517
Country	:	US
Telephone Number	:	281-550-0650
Fax Number	:	281-550-0590

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL CARL WALTHER JR.
Credential	:	D.C.
Telephone Number	:	281-550-0650

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	01/22/2019

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