Provider Demographics
NPI:1639364003
Name:MOORE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:MOORE FAMILY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FICPA
Authorized Official - Phone:281-997-0157
Mailing Address - Street 1:6302 BROADWAY ST
Mailing Address - Street 2:230
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7856
Mailing Address - Country:US
Mailing Address - Phone:281-997-0157
Mailing Address - Fax:281-997-5510
Practice Address - Street 1:6302 BROADWAY ST
Practice Address - Street 2:230
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7856
Practice Address - Country:US
Practice Address - Phone:281-997-0157
Practice Address - Fax:281-997-5510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty