Provider Demographics
NPI:1104173236
Name:TL CHIRO, LLC
Entity type:Organization
Organization Name:TL CHIRO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-494-1690
Mailing Address - Street 1:54 SUGAR CREEK CTR BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-494-1690
Mailing Address - Fax:281-494-1691
Practice Address - Street 1:54 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4064
Practice Address - Country:US
Practice Address - Phone:281-494-1690
Practice Address - Fax:281-494-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12403111N00000X
TX6971111N00000X
TX12020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1215013594OtherNPI
TX1114273851OtherNPI
TX1215013594OtherNPI