Provider Demographics
NPI:1508089855
Name:ILOANI, DAVID DAVIDSON O (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DAVIDSON O
Last Name:ILOANI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 BISSONNET ST
Mailing Address - Street 2:STE. # L
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8020
Mailing Address - Country:US
Mailing Address - Phone:713-270-6060
Mailing Address - Fax:713-270-8855
Practice Address - Street 1:9725 BISSONNET ST
Practice Address - Street 2:STE. # L
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8020
Practice Address - Country:US
Practice Address - Phone:713-270-6060
Practice Address - Fax:713-270-8855
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6078111N00000X, 111NR0200X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiology
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC06038305Medicaid
TX603830Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TXC06038305Medicaid