Provider Demographics
NPI:1295851301
Name:WESTCHASE WELLNESS CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:WESTCHASE WELLNESS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHUNG LUN
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-493-6886
Mailing Address - Street 1:11231 RICHMOND AVE STE 100A STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2673
Mailing Address - Country:US
Mailing Address - Phone:281-493-6886
Mailing Address - Fax:281-493-6811
Practice Address - Street 1:11231 RICHMOND AVE STE 100A STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2673
Practice Address - Country:US
Practice Address - Phone:281-493-6886
Practice Address - Fax:281-493-6811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV09145Medicare UPIN
TX8F2813Medicare ID - Type Unspecified