Provider Demographics
NPI:1386013803
Name:TEN13 GROUP, LLC
Entity Type:Organization
Organization Name:TEN13 GROUP, LLC
Other - Org Name:WELL-FIT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-533-8786
Mailing Address - Street 1:9601 KATY FWY
Mailing Address - Street 2:SUITE 430
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1342
Mailing Address - Country:US
Mailing Address - Phone:713-533-8786
Mailing Address - Fax:713-573-2798
Practice Address - Street 1:9601 KATY FWY
Practice Address - Street 2:SUITE 430
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1342
Practice Address - Country:US
Practice Address - Phone:713-533-8786
Practice Address - Fax:713-573-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12198305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization