Provider Demographics
NPI:1396914081
Name:ROCK SPORTS & SPINE THERAPY PLLC
Entity type:Organization
Organization Name:ROCK SPORTS & SPINE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:281-531-7465
Mailing Address - Street 1:14690 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-7518
Mailing Address - Country:US
Mailing Address - Phone:281-531-7465
Mailing Address - Fax:281-531-7657
Practice Address - Street 1:14690 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7518
Practice Address - Country:US
Practice Address - Phone:281-531-7465
Practice Address - Fax:281-531-7657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4340111NS0005X
TX10809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty