Provider Demographics
NPI:1821215294
Name:CY-FAIR CHIROPRACTIC ASSOCIATES,PC
Entity Type:Organization
Organization Name:CY-FAIR CHIROPRACTIC ASSOCIATES,PC
Other - Org Name:A.KENT RICE DC
Other - Org Type:Other Name
Authorized Official - Title/Position:INSURANCE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-955-6582
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:281-955-6582
Mailing Address - Fax:281-955-8188
Practice Address - Street 1:11514 FALLBROOK
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065
Practice Address - Country:US
Practice Address - Phone:281-955-6582
Practice Address - Fax:281-955-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0055MSOtherBCBS GROUP
TN8S5120OtherBCBS INDIV PROV #
TXDC2498OtherDC LICENSE
TX1790857852OtherINDIVIDUAL NPI
TX1790857852OtherINDIVIDUAL NPI
TN8S5120OtherBCBS INDIV PROV #