Provider Demographics
NPI:1215200597
Name:CROSSROADS CHIROPRACTIC AND WELLNESS,PLLC.
Entity Type:Organization
Organization Name:CROSSROADS CHIROPRACTIC AND WELLNESS,PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:NADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-970-5600
Mailing Address - Street 1:13141 FM 1960 RD W
Mailing Address - Street 2:STE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:281-970-5600
Mailing Address - Fax:281-970-5603
Practice Address - Street 1:13141 FM 1960 RD W
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065
Practice Address - Country:US
Practice Address - Phone:281-970-5600
Practice Address - Fax:281-970-5603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty