Provider Demographics
NPI:1568579951
Name:CONNELL, JOHN J (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:CONNELL
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 1:10934 I-10 EAST FREEWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029
Mailing Address - Country:US
Mailing Address - Phone:713-450-2838
Mailing Address - Fax:713-450-2843
Practice Address - Street 1:10934 I-10 EAST FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029
Practice Address - Country:US
Practice Address - Phone:713-450-2838
Practice Address - Fax:713-450-2843
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor