Provider Demographics
NPI:1174036271
Name:BRIDGELAND CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BRIDGELAND CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-775-4286
Mailing Address - Street 1:4545 POST OAK PLACE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3181
Mailing Address - Country:US
Mailing Address - Phone:713-622-5600
Mailing Address - Fax:713-622-5608
Practice Address - Street 1:4545 POST OAK PLACE DR STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3181
Practice Address - Country:US
Practice Address - Phone:713-622-5600
Practice Address - Fax:713-622-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty