Provider Demographics
NPI:1558581793
Name:KOALA LLP
Entity Type:Organization
Organization Name:KOALA LLP
Other - Org Name:KOALA HEALTH & WELLNESS CENTERS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-463-9111
Mailing Address - Street 1:PO BOX 890389
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-0389
Mailing Address - Country:US
Mailing Address - Phone:281-286-8520
Mailing Address - Fax:281-286-2947
Practice Address - Street 1:601 N AKARD ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3303
Practice Address - Country:US
Practice Address - Phone:214-969-6999
Practice Address - Fax:214-969-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0007EROtherBCBS GROUP ID