Provider Demographics
NPI:1093528226
Name:FUTRELL, MACKENZIE LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:LYNN
Last Name:FUTRELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 ROBINS WAY
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5836
Mailing Address - Country:US
Mailing Address - Phone:409-504-9219
Mailing Address - Fax:
Practice Address - Street 1:2770 FM 1463 RD STE 101B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7968
Practice Address - Country:US
Practice Address - Phone:346-257-4179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor