Provider Demographics
NPI:1609058700
Name:FORT BEND CHIROPRACTIC & REHAB CENTER,P.C.
Entity Type:Organization
Organization Name:FORT BEND CHIROPRACTIC & REHAB CENTER,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-277-2273
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-0139
Mailing Address - Country:US
Mailing Address - Phone:281-277-2273
Mailing Address - Fax:281-403-1189
Practice Address - Street 1:2855 DULLES AVE
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2950
Practice Address - Country:US
Practice Address - Phone:281-277-2273
Practice Address - Fax:281-499-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605049Medicare PIN