Provider Demographics
NPI:1427273291
Name:CHIROPRACTIC MEDICINE, PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC MEDICINE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-534-4987
Mailing Address - Street 1:1001 FM 517 RD E
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8664
Mailing Address - Country:US
Mailing Address - Phone:281-534-4987
Mailing Address - Fax:281-337-3118
Practice Address - Street 1:1001 FM 517 RD E
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8664
Practice Address - Country:US
Practice Address - Phone:281-534-4987
Practice Address - Fax:281-337-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0086PSOtherBC/BS
TX00Y278Medicare PIN