Provider Demographics
NPI:1801853619
Name:MUILENBURG, RALPH THEODORE (DC)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:THEODORE
Last Name:MUILENBURG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11514 FALLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4239
Mailing Address - Country:US
Mailing Address - Phone:281-955-9946
Mailing Address - Fax:281-469-0439
Practice Address - Street 1:11514 FALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4239
Practice Address - Country:US
Practice Address - Phone:281-955-9946
Practice Address - Fax:281-469-0439
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4491111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603323Medicare ID - Type UnspecifiedMDCR PROVIDER NUMBER