Provider Demographics
NPI:1881345064
Name:CRYO PERFORMANCE LLC
Entity type:Organization
Organization Name:CRYO PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:346-240-9868
Mailing Address - Street 1:4900 BISSONNET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4035
Mailing Address - Country:US
Mailing Address - Phone:346-240-9868
Mailing Address - Fax:
Practice Address - Street 1:4900 BISSONNET ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4035
Practice Address - Country:US
Practice Address - Phone:346-240-9868
Practice Address - Fax:281-476-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty