Provider Demographics
NPI:1114642824
Name:WASCOM, STEVE (DC)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:WASCOM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 COLLEGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4099
Mailing Address - Country:US
Mailing Address - Phone:281-362-0006
Mailing Address - Fax:
Practice Address - Street 1:1533 N SHEPHERD DR STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4185
Practice Address - Country:US
Practice Address - Phone:832-831-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15321111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician