Provider Demographics
NPI:1760416093
Name:ALISA-ONWAS, AUGUSTA C (DC)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTA
Middle Name:C
Last Name:ALISA-ONWAS
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 1:6511 GRAND CANYON GATE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8732
Mailing Address - Country:US
Mailing Address - Phone:281-829-2187
Mailing Address - Fax:713-490-2759
Practice Address - Street 1:6671 SOUTHWEST FWY
Practice Address - Street 2:SUITE 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2212
Practice Address - Country:US
Practice Address - Phone:713-988-4711
Practice Address - Fax:713-490-2759
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV07564Medicare UPIN
TX612110Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER