Provider Demographics
NPI:1376802306
Name:SMOUSE CHIROPRACTIC & SCOLIOSIS CENTER
Entity Type:Organization
Organization Name:SMOUSE CHIROPRACTIC & SCOLIOSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:281-494-5144
Mailing Address - Street 1:14015 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3554
Mailing Address - Country:US
Mailing Address - Phone:281-494-5144
Mailing Address - Fax:281-494-2975
Practice Address - Street 1:14015 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 9
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3554
Practice Address - Country:US
Practice Address - Phone:281-494-5144
Practice Address - Fax:281-494-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty