MEDICARE: CHIROTECTURE, 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	225100000X	Physical Therapist	1204543	TX
2	111N00000X	Chiropractor	11469	TX

General Provider Information

NPI Number	:	1679029987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROTECTURE, PLLC.

Provider Business Mailing Address
First Line	:	9415 BROADWAY ST.
Second Line	:	#121
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-416-5511
Fax Number	:	281-416-5549

Provider Business Practice Location Address
First Line	:	9415 BROADWAY ST.
Second Line	:	#121
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-416-5511
Fax Number	:	281-416-5549

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC RAMIREZ
Credential	:	D.C.
Telephone Number	:	281-416-5511

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	08/28/2016

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