Provider Demographics
NPI:1437346699
Name:WILCREST CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:WILCREST CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:X
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-530-0555
Mailing Address - Street 1:11700 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3618
Mailing Address - Country:US
Mailing Address - Phone:281-530-0555
Mailing Address - Fax:281-530-2555
Practice Address - Street 1:11700 SOUTHWEST FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3618
Practice Address - Country:US
Practice Address - Phone:281-530-0555
Practice Address - Fax:281-530-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty