Provider Demographics
NPI:1932262953
Name:KANZIC, JUDITH ANN (DC, FACO)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:KANZIC
Suffix:
Gender:F
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8955 KATY FWY
Mailing Address - Street 2:STE 102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1625
Mailing Address - Country:US
Mailing Address - Phone:713-683-6800
Mailing Address - Fax:713-683-0542
Practice Address - Street 1:7702 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-5029
Practice Address - Country:US
Practice Address - Phone:713-683-6800
Practice Address - Fax:713-683-0542
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4009111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601442Medicare ID - Type Unspecified