Provider Demographics
NPI:1891196481
Name:ELITE CHIRO GROUP LLC
Entity Type:Organization
Organization Name:ELITE CHIRO GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SIGG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-412-9642
Mailing Address - Street 1:1849 PEARLAND PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5343
Mailing Address - Country:US
Mailing Address - Phone:281-412-9642
Mailing Address - Fax:832-327-5121
Practice Address - Street 1:1849 PEARLAND PKWY STE 107
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5343
Practice Address - Country:US
Practice Address - Phone:281-412-9642
Practice Address - Fax:832-327-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty