Provider Demographics
NPI:1114152840
Name:ANI, MICHAEL O
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:O
Last Name:ANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 HILLCROFT ST
Mailing Address - Street 2:SUITE 416
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3190
Mailing Address - Country:US
Mailing Address - Phone:713-541-5577
Mailing Address - Fax:713-777-0791
Practice Address - Street 1:6420 HILLCROFT ST
Practice Address - Street 2:SUITE 416
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3190
Practice Address - Country:US
Practice Address - Phone:713-541-5577
Practice Address - Fax:713-777-0791
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF006263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF006263OtherTEXAS BOARD OF CHIROPRATORS