Provider Demographics
NPI:1831483726
Name:PEARLAND TOTAL BODYWORK LLC
Entity Type:Organization
Organization Name:PEARLAND TOTAL BODYWORK LLC
Other - Org Name:TOTAL BODYWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-480-7000
Mailing Address - Street 1:1018 HERCULES AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2722
Mailing Address - Country:US
Mailing Address - Phone:281-480-7000
Mailing Address - Fax:281-480-7017
Practice Address - Street 1:9415 BROADWAY ST
Practice Address - Street 2:SUITE 121
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5514
Practice Address - Country:US
Practice Address - Phone:281-480-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty