Provider Demographics
NPI:1730198433
Name:HMB HEALTHY MIND & BODY CHIROPRACTIC CLINIC PA
Entity type:Organization
Organization Name:HMB HEALTHY MIND & BODY CHIROPRACTIC CLINIC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-661-7979
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0525
Mailing Address - Country:US
Mailing Address - Phone:713-661-7979
Mailing Address - Fax:713-661-7980
Practice Address - Street 1:5900 CHIMNEY ROCK RD
Practice Address - Street 2:SUITE X
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2706
Practice Address - Country:US
Practice Address - Phone:713-661-7979
Practice Address - Fax:713-661-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9345111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00785WMedicare ID - Type UnspecifiedGROUP NUMBER