Provider Demographics
NPI:1336190677
Name:WOLTER, PHUONG MY-LE (DC)
Entity type:Individual
Prefix:DR
First Name:PHUONG MY-LE
Middle Name:
Last Name:WOLTER
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 1:10001 WESTHEIMER RD STE 2960
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3151
Mailing Address - Country:US
Mailing Address - Phone:713-587-0900
Mailing Address - Fax:713-587-0905
Practice Address - Street 1:10001 WESTHEIMER RD
Practice Address - Street 2:STE 2960
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3151
Practice Address - Country:US
Practice Address - Phone:713-587-0900
Practice Address - Fax:713-587-0905
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AB452OtherBLUE CROSS BLUE SHIELD OF