Provider Demographics
NPI:1629512280
Name:TEXAN WELLNESS CHIROPRACTIC & ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:TEXAN WELLNESS CHIROPRACTIC & ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:INDIRA
Authorized Official - Last Name:BAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:409-948-3094
Mailing Address - Street 1:3300 FM 1765
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-8147
Mailing Address - Country:US
Mailing Address - Phone:409-948-3094
Mailing Address - Fax:409-948-8574
Practice Address - Street 1:3300 FM 1765
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-8147
Practice Address - Country:US
Practice Address - Phone:409-948-3094
Practice Address - Fax:409-948-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty