Provider Demographics
NPI:1649283508
Name:NORTH SIDE PAIN RELIEF CENTER, INC
Entity type:Organization
Organization Name:NORTH SIDE PAIN RELIEF CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-652-0011
Mailing Address - Street 1:123 NORTHPOINT DR
Mailing Address - Street 2:STE 170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3228
Mailing Address - Country:US
Mailing Address - Phone:281-445-6944
Mailing Address - Fax:281-445-8009
Practice Address - Street 1:123 NORTHPOINT DR
Practice Address - Street 2:STE 170
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3228
Practice Address - Country:US
Practice Address - Phone:281-445-6944
Practice Address - Fax:281-445-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty