Provider Demographics
NPI:1770658403
Name:KISS, AGNES (DC)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:
Last Name:KISS
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 1:14620 FM 529 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3510
Mailing Address - Country:US
Mailing Address - Phone:281-855-0224
Mailing Address - Fax:281-855-0334
Practice Address - Street 1:14620 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-3510
Practice Address - Country:US
Practice Address - Phone:281-855-0224
Practice Address - Fax:281-855-0334
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor