Provider Demographics
NPI:1003032749
Name:CROWN CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:CROWN CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUVIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHARYA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-952-7696
Mailing Address - Street 1:PO BOX 571988
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77257-1988
Mailing Address - Country:US
Mailing Address - Phone:713-952-7696
Mailing Address - Fax:713-977-4201
Practice Address - Street 1:6630 HARWIN DR
Practice Address - Street 2:STE 140-144
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2245
Practice Address - Country:US
Practice Address - Phone:713-952-7696
Practice Address - Fax:713-977-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty