Provider Demographics
NPI:1770780785
Name:HOLIFIELD, STUART BROOKS III (DC)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:BROOKS
Last Name:HOLIFIELD
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3910 FAIRMONT PKWY # 321
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3076
Mailing Address - Country:US
Mailing Address - Phone:832-264-5425
Mailing Address - Fax:713-468-1830
Practice Address - Street 1:1160 BLALOCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7421
Practice Address - Country:US
Practice Address - Phone:713-468-1272
Practice Address - Fax:179-980-3905
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10657111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation