Provider Demographics
NPI:1851597256
Name:ASHFORD CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:ASHFORD CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-870-1233
Mailing Address - Street 1:1710 S DAIRY ASHFORD ST
Mailing Address - Street 2:STE 109
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3853
Mailing Address - Country:US
Mailing Address - Phone:281-870-1233
Mailing Address - Fax:281-870-1037
Practice Address - Street 1:1710 S DAIRY ASHFORD ST
Practice Address - Street 2:STE 109
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3853
Practice Address - Country:US
Practice Address - Phone:281-870-1233
Practice Address - Fax:281-870-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D83NOtherMEDICARE GROUP #