Provider Demographics
NPI:1477826584
Name:HOUSTON SPINAL PAIN & REHAB CLINIC
Entity Type:Organization
Organization Name:HOUSTON SPINAL PAIN & REHAB CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THO
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-260-7774
Mailing Address - Street 1:414B N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3508
Mailing Address - Country:US
Mailing Address - Phone:281-260-7774
Mailing Address - Fax:281-260-7779
Practice Address - Street 1:414B N SAM HOUSTON PKWY E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3508
Practice Address - Country:US
Practice Address - Phone:281-260-7774
Practice Address - Fax:281-260-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8461111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty