Provider Demographics
NPI:1467788661
Name:MARINO CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MARINO CHIROPRACTIC PC
Other - Org Name:MARINO CHIROPRACTIC PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-486-0221
Mailing Address - Street 1:17313 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2718
Mailing Address - Country:US
Mailing Address - Phone:281-486-0221
Mailing Address - Fax:
Practice Address - Street 1:17313 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2718
Practice Address - Country:US
Practice Address - Phone:281-486-0221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty