Provider Demographics
NPI:1043645369
Name:FRONTLINE RECOVERY & CONSULTING
Entity Type:Organization
Organization Name:FRONTLINE RECOVERY & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-831-6639
Mailing Address - Street 1:8700 COMMERCE PARK DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7497
Mailing Address - Country:US
Mailing Address - Phone:832-831-6639
Mailing Address - Fax:832-831-6643
Practice Address - Street 1:8700 COMMERCE PARK DR
Practice Address - Street 2:SUITE 245
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7432
Practice Address - Country:US
Practice Address - Phone:832-831-6639
Practice Address - Fax:832-831-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0010541111NR0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty