Provider Demographics
NPI:1851716658
Name:ZUKERAN, AMMON (DC)
Entity Type:Individual
Prefix:
First Name:AMMON
Middle Name:
Last Name:ZUKERAN
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 1:6326 ALPINE TRAIL LN
Mailing Address - Street 2:SUITE 109
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3184
Mailing Address - Country:US
Mailing Address - Phone:808-658-0257
Mailing Address - Fax:808-658-0257
Practice Address - Street 1:6326 ALPINE TRAIL LN
Practice Address - Street 2:SUITE 109
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3184
Practice Address - Country:US
Practice Address - Phone:808-658-0257
Practice Address - Fax:808-658-0257
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1270111N00000X
TX13067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor