Provider Demographics
NPI:1821220435
Name:BORGSTROM, KAI (DC, CCSP)
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:
Last Name:BORGSTROM
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 MARINA BAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3984
Mailing Address - Country:US
Mailing Address - Phone:281-334-9300
Mailing Address - Fax:281-334-9301
Practice Address - Street 1:3033 MARINA BAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3984
Practice Address - Country:US
Practice Address - Phone:281-334-9300
Practice Address - Fax:281-334-9301
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor