Provider Demographics
NPI:1407305964
Name:MACKEY, JENNIFER (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MACKEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12830 REDFERN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77048-4136
Mailing Address - Country:US
Mailing Address - Phone:281-536-9986
Mailing Address - Fax:
Practice Address - Street 1:25626 NORTHWEST FWY
Practice Address - Street 2:STE. 700
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1463
Practice Address - Country:US
Practice Address - Phone:281-758-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor