Provider Demographics
NPI:1639317761
Name:GLOBKE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:GLOBKE FAMILY CHIROPRACTIC
Other - Org Name:DICKINSON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LELAND
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GLOBKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-337-6007
Mailing Address - Street 1:2320 FM 517 RD E STE B
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8623
Mailing Address - Country:US
Mailing Address - Phone:281-337-6007
Mailing Address - Fax:281-337-0013
Practice Address - Street 1:2320 FM 517 RD E STE B
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8623
Practice Address - Country:US
Practice Address - Phone:281-337-6007
Practice Address - Fax:281-337-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOA3351Medicare PIN