Provider Demographics
NPI:1083825376
Name:BACK TO BALANCE CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:BACK TO BALANCE CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANGYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:281-596-8868
Mailing Address - Street 1:12574 WESTHEIMER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5808
Mailing Address - Country:US
Mailing Address - Phone:281-596-8868
Mailing Address - Fax:281-596-8878
Practice Address - Street 1:12574 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5808
Practice Address - Country:US
Practice Address - Phone:281-596-8868
Practice Address - Fax:281-596-8878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU90687Medicare UPIN
TX8083B7Medicare ID - Type Unspecified