Provider Demographics
NPI:1619171857
Name:ANYADIKE, LARY
Entity Type:Individual
Prefix:MR
First Name:LARY
Middle Name:
Last Name:ANYADIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6666 HARWIN DR
Mailing Address - Street 2:SUITE 655
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2292
Mailing Address - Country:US
Mailing Address - Phone:713-952-3900
Mailing Address - Fax:713-952-4371
Practice Address - Street 1:6666 HARWIN DR
Practice Address - Street 2:SUITE 655
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2292
Practice Address - Country:US
Practice Address - Phone:713-952-3900
Practice Address - Fax:713-952-4371
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF005752111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation