Provider Demographics
NPI:1669965653
Name:INVICTUS CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:INVICTUS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-900-9922
Mailing Address - Street 1:11510 BARKER CYPRESS RD STE 125
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1216
Mailing Address - Country:US
Mailing Address - Phone:832-900-9922
Mailing Address - Fax:
Practice Address - Street 1:11510 BARKER CYPRESS RD STE 125
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1216
Practice Address - Country:US
Practice Address - Phone:832-900-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty