Provider Demographics
NPI:1336386606
Name:WELCH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:WELCH CHIROPRACTIC LLC
Other - Org Name:BEAUMONT SPINAL CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:409-833-5600
Mailing Address - Street 1:4220 TREADWAY RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7105
Mailing Address - Country:US
Mailing Address - Phone:409-833-5600
Mailing Address - Fax:409-833-2111
Practice Address - Street 1:4220 TREADWAY RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7105
Practice Address - Country:US
Practice Address - Phone:409-833-5600
Practice Address - Fax:409-833-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT16544Medicare UPIN