Provider Demographics
NPI:1740918382
Name:RILEY, JADA LIAN (DC)
Entity type:Individual
Prefix:DR
First Name:JADA
Middle Name:LIAN
Last Name:RILEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12100 S HIGHWAY 6 APT 7305
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-5718
Mailing Address - Country:US
Mailing Address - Phone:512-743-5032
Mailing Address - Fax:
Practice Address - Street 1:2340 TEXAS HERITAGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77494-4635
Practice Address - Country:US
Practice Address - Phone:832-913-8970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor