Provider Demographics
NPI:1699248419
Name:101 R LLC
Entity type:Organization
Organization Name:101 R LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUEING
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:281-989-9419
Mailing Address - Street 1:9000 SOUTHWEST FWY STE 204
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1520
Mailing Address - Country:US
Mailing Address - Phone:832-962-7966
Mailing Address - Fax:832-962-7991
Practice Address - Street 1:9000 SOUTHWEST FWY STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1520
Practice Address - Country:US
Practice Address - Phone:832-962-7966
Practice Address - Fax:832-962-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1568843472Other111NR0400X