Provider Demographics
NPI:1467634519
Name:SPINAL CARE CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:SPINAL CARE CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SCHWAB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-292-6644
Mailing Address - Street 1:9303 PINECROFT DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3180
Mailing Address - Country:US
Mailing Address - Phone:281-292-6644
Mailing Address - Fax:281-298-1132
Practice Address - Street 1:9303 PINECROFT DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3180
Practice Address - Country:US
Practice Address - Phone:281-292-6644
Practice Address - Fax:281-298-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00169RMedicare PIN