Provider Demographics
NPI:1114545266
Name:PEAK POTENTIAL HOUSTON HEIGHTS LLC
Entity Type:Organization
Organization Name:PEAK POTENTIAL HOUSTON HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DC
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BEUKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-266-0870
Mailing Address - Street 1:6212 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-2496
Mailing Address - Country:US
Mailing Address - Phone:832-266-0870
Mailing Address - Fax:
Practice Address - Street 1:6212 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-2496
Practice Address - Country:US
Practice Address - Phone:832-266-0870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty