Provider Demographics
NPI:1952846883
Name:NORTHWEST CLINIC
Entity Type:Organization
Organization Name:NORTHWEST CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UZZIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGSBY
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:713-842-7958
Mailing Address - Street 1:5005 W 34TH ST
Mailing Address - Street 2:SUITE 204A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-4200
Mailing Address - Country:US
Mailing Address - Phone:713-842-7958
Mailing Address - Fax:713-842-7959
Practice Address - Street 1:5005 W 34TH ST
Practice Address - Street 2:SUITE 204A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-4200
Practice Address - Country:US
Practice Address - Phone:713-842-7958
Practice Address - Fax:713-842-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060111N00000X
111NP0017X, 111NR0400X, 111NX0100X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty