Provider Demographics
NPI:1982936654
Name:BACK IN ACTION CHIROPRACTIC
Entity type:Organization
Organization Name:BACK IN ACTION CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:COY
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:281-648-0001
Mailing Address - Street 1:699 S FRIENDSWOOD DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4579
Mailing Address - Country:US
Mailing Address - Phone:281-648-0001
Mailing Address - Fax:281-648-0146
Practice Address - Street 1:699 S FRIENDSWOOD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4579
Practice Address - Country:US
Practice Address - Phone:281-648-0001
Practice Address - Fax:281-648-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty