Provider Demographics
NPI:1154104347
Name:HUMBLE BACK CLINIC
Entity type:Organization
Organization Name:HUMBLE BACK CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-775-4286
Mailing Address - Street 1:18842 S MEMORIAL DR STE 204
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4229
Mailing Address - Country:US
Mailing Address - Phone:281-719-9500
Mailing Address - Fax:281-719-9530
Practice Address - Street 1:18842 S MEMORIAL DR STE 204
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4229
Practice Address - Country:US
Practice Address - Phone:281-719-9500
Practice Address - Fax:281-719-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty