Provider Demographics
NPI:1982691556
Name:BALOGUN, RAZAK (DC)
Entity type:Individual
Prefix:DR
First Name:RAZAK
Middle Name:
Last Name:BALOGUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:RAZAK
Other - Middle Name:
Other - Last Name:BALOGUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5600 S WILLOW DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4713
Mailing Address - Country:US
Mailing Address - Phone:713-726-9111
Mailing Address - Fax:713-726-9112
Practice Address - Street 1:5600 S WILLOW DR
Practice Address - Street 2:SUITE 115
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4713
Practice Address - Country:US
Practice Address - Phone:713-726-9111
Practice Address - Fax:713-726-9112
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9304111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608017OtherBLUE CROSS BLUE SHIELD