MEDICARE: APEX CHIROPRACTIC CLINIC, LLC

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	:	1528702230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX CHIROPRACTIC CLINIC, LLC

Provider Business Mailing Address
First Line	:	14811 SAINT MARYS LN STE 155
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-2917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14811 SAINT MARYS LN STE 155
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-2917
Country	:	US
Telephone Number	:	281-752-7388
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN WAFER
Credential	:	DC
Telephone Number	:	281-752-7388

Provider Enumeration Date	:	04/27/2022
Last Update Date	:	04/27/2022

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