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NPI Code Detail

MEDICARE: COMPLETE BODYWORK AND WELLNESS PLLC

MEDICARE: COMPLETE BODYWORK AND WELLNESS 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1356983712
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPLETE BODYWORK AND WELLNESS PLLC
Provider Business Mailing Address
First Line : 1880 S DAIRY ASHFORD RD STE 105
Second Line :
City : HOUSTON
State : TX
Zip : 77077-4759
Country : US
Telephone Number : 281-870-1233
Fax Number : 281-870-1037
Provider Business Practice Location Address
First Line : 1880 S DAIRY ASHFORD RD STE 105
Second Line :
City : HOUSTON
State : TX
Zip : 77077-4759
Country : US
Telephone Number : 281-870-1233
Fax Number : 281-870-1037
Authorized Official
Title or Position : OWNER/PROVIDER
Name : DR. SHANNON L HICKMAN
Credential : DC
Telephone Number : 281-870-1233
Provider Enumeration Date : 10/16/2019
Last Update Date : 10/16/2019

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Directions to “COMPLETE BODYWORK AND WELLNESS PLLC ” Practice Location

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