Provider Demographics
NPI:1801071493
Name:WESTBURY CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:WESTBURY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURDETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-667-7463
Mailing Address - Street 1:4666 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1804
Mailing Address - Country:US
Mailing Address - Phone:713-667-7463
Mailing Address - Fax:
Practice Address - Street 1:4666 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1804
Practice Address - Country:US
Practice Address - Phone:713-667-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty