Provider Demographics
NPI:1730303546
Name:CORE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CORE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-622-3300
Mailing Address - Street 1:1770 SAINT JAMES PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3471
Mailing Address - Country:US
Mailing Address - Phone:713-622-3300
Mailing Address - Fax:713-622-3207
Practice Address - Street 1:1770 SAINT JAMES PL
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3471
Practice Address - Country:US
Practice Address - Phone:713-622-3300
Practice Address - Fax:713-622-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111N00000XOtherCHIROPRACTOR