Provider Demographics
NPI:1558573857
Name:SORRELS, KENNETH REGINALD (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:REGINALD
Last Name:SORRELS
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 1:2228 COUNTY ROAD 737
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-1311
Mailing Address - Country:US
Mailing Address - Phone:281-331-8992
Mailing Address - Fax:
Practice Address - Street 1:2228 COUNTY ROAD 737
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-1311
Practice Address - Country:US
Practice Address - Phone:281-331-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor