Provider Demographics
NPI:1285803874
Name:KENNEDY, WILLIAM BARTON JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BARTON
Last Name:KENNEDY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14690 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-7518
Mailing Address - Country:US
Mailing Address - Phone:281-531-7465
Mailing Address - Fax:281-531-7657
Practice Address - Street 1:14690 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7518
Practice Address - Country:US
Practice Address - Phone:281-531-7465
Practice Address - Fax:281-531-7657
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10809111N00000X
TX4340111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor