MEDICARE: ENVISION WELLNESS CENTRE

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	7018	TX

General Provider Information

NPI Number	:	1346614427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISION WELLNESS CENTRE

Provider Business Mailing Address
First Line	:	17629 EL CAMINO REAL
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77058-2901
Country	:	US
Telephone Number	:	281-486-7044
Fax Number	:	281-674-8443

Provider Business Practice Location Address
First Line	:	17629 EL CAMINO REAL
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77058-2901
Country	:	US
Telephone Number	:	281-486-7044
Fax Number	:	281-674-8443

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID KINGCAID
Credential	:	D.C.
Telephone Number	:	281-687-0082

Provider Enumeration Date	:	11/30/2015
Last Update Date	:	11/30/2015

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Directions to “ENVISION WELLNESS CENTRE ” Practice Location

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