Provider Demographics
NPI:1306173380
Name:FORT BEND CHIROPRACTIC & WELLNESS
Entity type:Organization
Organization Name:FORT BEND CHIROPRACTIC & WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-352-0406
Mailing Address - Street 1:901 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2605
Mailing Address - Country:US
Mailing Address - Phone:281-238-5767
Mailing Address - Fax:281-232-1949
Practice Address - Street 1:901 3RD ST
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2605
Practice Address - Country:US
Practice Address - Phone:281-238-5767
Practice Address - Fax:281-232-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4488111N00000X
TX4445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty