Provider Demographics
NPI:1255477287
Name:DELTA CLINIC
Entity Type:Organization
Organization Name:DELTA CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:WARRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-721-2737
Mailing Address - Street 1:PO BOX 710969
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271
Mailing Address - Country:US
Mailing Address - Phone:713-721-2737
Mailing Address - Fax:713-721-2737
Practice Address - Street 1:12935 S MAIN STREET
Practice Address - Street 2:#100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035
Practice Address - Country:US
Practice Address - Phone:713-721-2737
Practice Address - Fax:713-721-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty