MEDICARE: ELITE FAMILY CHIROPRACTIC 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1811672678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE FAMILY CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	9070 GLEANNLOCH FOREST DR STE 301
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-1698
Country	:	US
Telephone Number	:	346-367-9747
Fax Number	:

Provider Business Practice Location Address
First Line	:	9070 GLEANNLOCH FOREST DR STE 301
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-1698
Country	:	US
Telephone Number	:	346-367-9747
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RYLAN C HOLUB
Credential	:	DC
Telephone Number	:	281-702-1304

Provider Enumeration Date	:	06/20/2023
Last Update Date	:	06/20/2023

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