MEDICARE: GOLDEN CHIROPRACTIC CLINIC, PC

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	7290	TX

General Provider Information

NPI Number	:	1992975429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN CHIROPRACTIC CLINIC, PC

Provider Business Mailing Address
First Line	:	12846 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-5708
Country	:	US
Telephone Number	:	713-453-1091
Fax Number	:	713-513-5067

Provider Business Practice Location Address
First Line	:	12846 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-5708
Country	:	US
Telephone Number	:	713-453-1091
Fax Number	:	713-513-5067

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. CHAD STEPHEN GOLDEN
Credential	:	D.C.
Telephone Number	:	713-453-1091

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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