Provider Demographics
NPI:1326056698
Name:MICHAEL C. WALTHER JR. D.C.
Entity Type:Organization
Organization Name:MICHAEL C. WALTHER JR. D.C.
Other - Org Name:COPPERFIELD FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:WALTHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:281-550-0650
Mailing Address - Street 1:7171 HIGHWAY 6 N STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2422
Mailing Address - Country:US
Mailing Address - Phone:281-550-0650
Mailing Address - Fax:281-815-3678
Practice Address - Street 1:7050 LAKEVIEW HAVEN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2517
Practice Address - Country:US
Practice Address - Phone:281-550-0650
Practice Address - Fax:281-550-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2237276OtherFIRST HEALTH
TX606673OtherBCBS
TX662634OtherUNITED HEALTHCARE
TX606673OtherBCBS
TXU99050Medicare UPIN