Provider Demographics
NPI:1710250394
Name:MCDANIEL, AMY (DC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MCDANIEL
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 1:355 E NASA
Mailing Address - Street 2:SUITE M
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-5349
Mailing Address - Country:US
Mailing Address - Phone:832-283-5220
Mailing Address - Fax:
Practice Address - Street 1:3909 LIVINGSTON LAKE CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4798
Practice Address - Country:US
Practice Address - Phone:832-283-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor