Provider Demographics
NPI:1831439843
Name:HOLZBACH CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:HOLZBACH CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:LE
Authorized Official - Last Name:HOLZBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-968-9080
Mailing Address - Street 1:20801 GULF FWY
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-6419
Mailing Address - Country:US
Mailing Address - Phone:281-968-9080
Mailing Address - Fax:281-968-0618
Practice Address - Street 1:20801 GULF FWY
Practice Address - Street 2:SUITE 20
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-6419
Practice Address - Country:US
Practice Address - Phone:281-968-9080
Practice Address - Fax:281-968-0618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty