Provider Demographics
NPI:1205431236
Name:100 PERCENT CHIROPRACTIC LIVINGOOD TX PLLC
Entity type:Organization
Organization Name:100 PERCENT CHIROPRACTIC LIVINGOOD TX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-409-6006
Mailing Address - Street 1:10123 LOUETTA RD STE B200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2160
Mailing Address - Country:US
Mailing Address - Phone:832-843-6632
Mailing Address - Fax:832-514-6836
Practice Address - Street 1:30129 ROCK CREEK DR STE 1000
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2869
Practice Address - Country:US
Practice Address - Phone:346-616-5154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty