Provider Demographics
NPI:1770746752
Name:IN LINE CHIROPRACTIC CARE PA
Entity type:Organization
Organization Name:IN LINE CHIROPRACTIC CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-699-3200
Mailing Address - Street 1:4625 NORTH FWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-2914
Mailing Address - Country:US
Mailing Address - Phone:713-699-3200
Mailing Address - Fax:713-699-3234
Practice Address - Street 1:4625 NORTH FWY
Practice Address - Street 2:SUITE 205
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2914
Practice Address - Country:US
Practice Address - Phone:713-699-3200
Practice Address - Fax:713-856-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73845Medicare UPIN