Provider Demographics
NPI:1881697357
Name:WALTHER, MICHAEL CARL JR (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CARL
Last Name:WALTHER
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:7171 HIGHWAY 6 N STE 210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2422
Mailing Address - Country:US
Mailing Address - Phone:281-550-0650
Mailing Address - Fax:281-815-3678
Practice Address - Street 1:7050 LAKEVIEW HAVEN DR
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2517
Practice Address - Country:US
Practice Address - Phone:281-550-0650
Practice Address - Fax:281-550-0590
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2019-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX6924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX662634OtherACN
TX2237276OtherFIRST HEALTH
TX606673OtherBLUE CROSS BLUE SHIELD
TX662634OtherGREAT WEST
TX662634OtherUNITED HEALTHCARE
TX662634OtherACN
TX8B6838Medicare ID - Type Unspecified