Provider Demographics
NPI:1407019714
Name:CHIROCARE OF TEXAS
Entity Type:Organization
Organization Name:CHIROCARE OF TEXAS
Other - Org Name:ELITE WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINGCAID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-486-7044
Mailing Address - Street 1:803 E NASA RD 1 STE 114
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-5303
Mailing Address - Country:US
Mailing Address - Phone:281-486-7044
Mailing Address - Fax:
Practice Address - Street 1:803 E NASA RD 1 STE 114
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5303
Practice Address - Country:US
Practice Address - Phone:281-486-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7018261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU62353Medicare UPIN
TX0055GSMedicare PIN