Provider Demographics
NPI:1083029185
Name:COBB FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:COBB FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-851-0354
Mailing Address - Street 1:3965 PHELAN BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-2231
Mailing Address - Country:US
Mailing Address - Phone:409-835-7676
Mailing Address - Fax:409-835-5106
Practice Address - Street 1:3965 PHELAN BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-2231
Practice Address - Country:US
Practice Address - Phone:409-835-7676
Practice Address - Fax:409-835-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11253261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service