Provider Demographics
NPI:1144339029
Name:LE TEXAS SPINAL CARE CLINIC PLLC
Entity type:Organization
Organization Name:LE TEXAS SPINAL CARE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHUNG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-278-2225
Mailing Address - Street 1:2600 S GESSNER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3216
Mailing Address - Country:US
Mailing Address - Phone:713-278-2225
Mailing Address - Fax:713-917-0604
Practice Address - Street 1:2600 S GESSNER RD STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3216
Practice Address - Country:US
Practice Address - Phone:713-278-2225
Practice Address - Fax:713-917-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H3925OtherBLUE CROSS BLUE SHIELD
10619674OtherCAQH