Provider Demographics
NPI:1487204889
Name:MOSS FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:MOSS FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-799-7291
Mailing Address - Street 1:4306 ECHO FALLS DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1046
Mailing Address - Country:US
Mailing Address - Phone:281-799-7291
Mailing Address - Fax:
Practice Address - Street 1:1380 STONEHOLLOW DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1773
Practice Address - Country:US
Practice Address - Phone:281-358-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty