Provider Demographics
NPI:1427569789
Name:TYP CHIROPRACTIC,LLC
Entity Type:Organization
Organization Name:TYP CHIROPRACTIC,LLC
Other - Org Name:WE GOT YOUR BACK CHIROPRACTIC REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-749-1861
Mailing Address - Street 1:1900 NORTH LOOP W STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8100
Mailing Address - Country:US
Mailing Address - Phone:281-749-1861
Mailing Address - Fax:281-749-1871
Practice Address - Street 1:1900 NORTH LOOP W STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8100
Practice Address - Country:US
Practice Address - Phone:281-749-1861
Practice Address - Fax:281-749-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13576462OtherCAQH