Provider Demographics
NPI:1366808271
Name:NORTH WELLNESS & CHIRO CENTER
Entity type:Organization
Organization Name:NORTH WELLNESS & CHIRO CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:VENCE
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-906-6746
Mailing Address - Street 1:4141 NORTH FWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-4208
Mailing Address - Country:US
Mailing Address - Phone:713-906-6746
Mailing Address - Fax:
Practice Address - Street 1:4141 NORTH FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-4208
Practice Address - Country:US
Practice Address - Phone:713-906-6746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0011610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty