Provider Demographics
NPI:1508185679
Name:CHIRIBOGA, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CHIRIBOGA
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 1:13141 FM 1960 RD W
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5278
Mailing Address - Country:US
Mailing Address - Phone:281-970-5600
Mailing Address - Fax:281-970-5603
Practice Address - Street 1:13141 FM 1960 RD W
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5278
Practice Address - Country:US
Practice Address - Phone:281-970-5600
Practice Address - Fax:281-970-5603
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor