Provider Demographics
NPI:1275604084
Name:LAVOIE, RONALD EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EDWARD
Last Name:LAVOIE
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 1:25300 BOROUGH PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3552
Mailing Address - Country:US
Mailing Address - Phone:281-367-0404
Mailing Address - Fax:281-298-5248
Practice Address - Street 1:16460 KUYKENDAHL RD STE 178
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-2758
Practice Address - Country:US
Practice Address - Phone:281-583-9191
Practice Address - Fax:281-298-5248
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC6228OtherUHC
TX2859199OtherCIGNA
TXDC6228Medicaid
TX0007677051OtherAETNA
TX0007677051OtherAETNA
TX8492K0Medicare ID - Type UnspecifiedMEDICARE