Provider Demographics
NPI:1740053552
Name:OMNI HEALTH CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:OMNI HEALTH CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-605-3762
Mailing Address - Street 1:17102 HIGHWAY 46 W STE 14
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-7120
Mailing Address - Country:US
Mailing Address - Phone:830-214-2211
Mailing Address - Fax:
Practice Address - Street 1:17102 HIGHWAY 46 W STE 14
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-7120
Practice Address - Country:US
Practice Address - Phone:830-214-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty