Provider Demographics
NPI:1689816126
Name:FARRIS-NELSON, CAROL ELAINE
Entity Type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:ELAINE
Last Name:FARRIS-NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8799 NORTH LOOP E
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1213
Mailing Address - Country:US
Mailing Address - Phone:713-977-6767
Mailing Address - Fax:713-672-1224
Practice Address - Street 1:8799 NORTH LOOP E
Practice Address - Street 2:SUITE 208
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1213
Practice Address - Country:US
Practice Address - Phone:713-977-6767
Practice Address - Fax:713-672-1224
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF008485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor