Provider Demographics
NPI:1457504698
Name:FRIENDSWOOD DOCTORS OF CHIROPRACTIC
Entity Type:Organization
Organization Name:FRIENDSWOOD DOCTORS OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-996-7600
Mailing Address - Street 1:903 S FRIENDSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4855
Mailing Address - Country:US
Mailing Address - Phone:281-996-7600
Mailing Address - Fax:281-996-6988
Practice Address - Street 1:903 S FRIENDSWOOD DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4855
Practice Address - Country:US
Practice Address - Phone:281-996-7600
Practice Address - Fax:281-996-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6279261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care