Provider Demographics
NPI:1467702662
Name:BAY OAKS PHYSICAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:BAY OAKS PHYSICAL MEDICINE, PLLC
Other - Org Name:BAY OAKS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUCHON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-557-5525
Mailing Address - Street 1:17080 HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4129
Mailing Address - Country:US
Mailing Address - Phone:281-557-5525
Mailing Address - Fax:281-557-5517
Practice Address - Street 1:17080 HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4129
Practice Address - Country:US
Practice Address - Phone:281-557-5525
Practice Address - Fax:281-557-5517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty