Provider Demographics
NPI:1750487088
Name:VANDYKEN INC
Entity Type:Organization
Organization Name:VANDYKEN INC
Other - Org Name:BACK IN BALANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDYKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-298-9899
Mailing Address - Street 1:7215 SPRING CYPRESS RD APT 1222
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3290
Mailing Address - Country:US
Mailing Address - Phone:281-298-9899
Mailing Address - Fax:281-298-5686
Practice Address - Street 1:7215 SPRING CYPRESS RD APT 1222
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3290
Practice Address - Country:US
Practice Address - Phone:281-298-9899
Practice Address - Fax:281-298-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty