Provider Demographics
NPI:1295842789
Name:MORYSON, MIROSLAWA (DC)
Entity Type:Individual
Prefix:
First Name:MIROSLAWA
Middle Name:
Last Name:MORYSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24518 NORTHCREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4916
Mailing Address - Country:US
Mailing Address - Phone:281-320-8069
Mailing Address - Fax:
Practice Address - Street 1:17811 BAMWOOD DR # 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1854
Practice Address - Country:US
Practice Address - Phone:281-582-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S6000OtherBCBS