Provider Demographics
NPI:1306224423
Name:CROSSCHIRO, INC
Entity Type:Organization
Organization Name:CROSSCHIRO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIRIBOGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-970-5600
Mailing Address - Street 1:13141 FM 1960 RD W STE 700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5309
Mailing Address - Country:US
Mailing Address - Phone:281-970-5600
Mailing Address - Fax:281-970-5603
Practice Address - Street 1:13141 FM 1960
Practice Address - Street 2:#700
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:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTIN