MEDICARE: WOLFE CHIROPRACTIC CLINIC, P.A.

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	7362	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	605773	OTHER	TX	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1932237641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOLFE CHIROPRACTIC CLINIC, P.A.

Provider Business Mailing Address
First Line	:	200 E HOUSTON ST
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4512
Country	:	US
Telephone Number	:	281-592-6757
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E HOUSTON ST
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4512
Country	:	US
Telephone Number	:	281-592-6757
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBERT WAYNE WOLFE II
Credential	:	D.C.
Telephone Number	:	281-592-6757

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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