Provider Demographics
NPI:1689387672
Name:PADILLA, INGRID (DC)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 NW CENTRAL DR # F111
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2053
Mailing Address - Country:US
Mailing Address - Phone:713-690-4150
Mailing Address - Fax:713-690-4175
Practice Address - Street 1:5715 NW CENTRAL DR # F111
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2053
Practice Address - Country:US
Practice Address - Phone:713-690-4150
Practice Address - Fax:713-690-4175
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15405OtherTEXAS BOARD OF CHIROPRACTIC EXAMINERS