Provider Demographics
NPI:1194160184
Name:DERMODY, GINA LYNN (DC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:LYNN
Last Name:DERMODY
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 1:12850 JONES RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4956
Mailing Address - Country:US
Mailing Address - Phone:281-664-2250
Mailing Address - Fax:
Practice Address - Street 1:12850 JONES RD STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4956
Practice Address - Country:US
Practice Address - Phone:281-664-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor