Provider Demographics
NPI:1093927287
Name:BIELAMOWICZ-TYNAN, MARIE C (DC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:BIELAMOWICZ-TYNAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:C
Other - Last Name:BIELAMOWICZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77270-7527
Mailing Address - Country:US
Mailing Address - Phone:713-861-6186
Mailing Address - Fax:713-861-6186
Practice Address - Street 1:3206 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2642
Practice Address - Country:US
Practice Address - Phone:713-861-6186
Practice Address - Fax:713-861-6186
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor