Provider Demographics
NPI:1992975429
Name:GOLDEN CHIROPRACTIC CLINIC, PC
Entity type:Organization
Organization Name:GOLDEN CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-453-1091
Mailing Address - Street 1:12846 EAST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5708
Mailing Address - Country:US
Mailing Address - Phone:713-453-1091
Mailing Address - Fax:713-513-5067
Practice Address - Street 1:12846 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5708
Practice Address - Country:US
Practice Address - Phone:713-453-1091
Practice Address - Fax:713-513-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU66865Medicare UPIN