Provider Demographics
NPI:1235138892
Name:MAHAN, MICK (DC)
Entity Type:Individual
Prefix:DR
First Name:MICK
Middle Name:
Last Name:MAHAN
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 1:16259 FM 529 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1433
Mailing Address - Country:US
Mailing Address - Phone:281-345-4450
Mailing Address - Fax:281-345-4449
Practice Address - Street 1:16259 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1433
Practice Address - Country:US
Practice Address - Phone:281-345-4450
Practice Address - Fax:281-345-4449
Is Sole Proprietor?:No
Enumeration Date:2005-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor