Provider Demographics
NPI:1699917377
Name:WELLCARE CHIROPRACTIC AND REHABILITATION CLINIC
Entity type:Organization
Organization Name:WELLCARE CHIROPRACTIC AND REHABILITATION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:AYODEJI
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:832-883-2956
Mailing Address - Street 1:10101 HARWIN DR STE 324
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1737
Mailing Address - Country:US
Mailing Address - Phone:832-883-2956
Mailing Address - Fax:
Practice Address - Street 1:10101 HARWIN DR STE 324
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1737
Practice Address - Country:US
Practice Address - Phone:832-883-2956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty