Provider Demographics
NPI:1033522875
Name:NASA CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:NASA CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:CASE
Authorized Official - Last Name:RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-486-1675
Mailing Address - Street 1:415 NARCISSUS RD
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2440
Mailing Address - Country:US
Mailing Address - Phone:832-693-0366
Mailing Address - Fax:281-486-1677
Practice Address - Street 1:940 GEMINI ST STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2763
Practice Address - Country:US
Practice Address - Phone:281-486-1675
Practice Address - Fax:281-486-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty