Provider Demographics
NPI:1760774517
Name:HOUSTON PAIN RELIEF AND WELLNESS CLINIC
Entity Type:Organization
Organization Name:HOUSTON PAIN RELIEF AND WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHUC
Authorized Official - Middle Name:V
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-212-6323
Mailing Address - Street 1:7001 CORPORATE DRIVE
Mailing Address - Street 2:SUITE 133
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:832-212-6323
Mailing Address - Fax:
Practice Address - Street 1:7001 CORPORATE DRIVE
Practice Address - Street 2:SUITE 133
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:832-212-6323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty