Provider Demographics
NPI:1629469358
Name:BRACKNEY, MATTHEW EVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:EVAN
Last Name:BRACKNEY
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 1:4295 SAN FELIPE ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-2942
Mailing Address - Country:US
Mailing Address - Phone:713-629-9200
Mailing Address - Fax:713-513-5048
Practice Address - Street 1:1801 KINGWOOD DR
Practice Address - Street 2:SUITE 180
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3060
Practice Address - Country:US
Practice Address - Phone:713-629-9200
Practice Address - Fax:713-513-5048
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor