1205023348 NPI number — BURLEIGH CHIROPRACTIC CENTER PC

Table of content: (NPI 1205023348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205023348 NPI number — BURLEIGH CHIROPRACTIC CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BURLEIGH CHIROPRACTIC CENTER PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205023348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7825 HIGHWAY 6 N STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77095-1705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-237-3331
Provider Business Mailing Address Fax Number:
832-237-4638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7825 HIGHWAY 6 N STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77095-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-237-3331
Provider Business Practice Location Address Fax Number:
832-237-4638
Provider Enumeration Date:
10/03/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BURLEIGH
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
832-237-3331

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: U18602 . This is a "UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".