Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 12946 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 12946 | MI |
NPI | 1073997342 |
---|---|
Provider Name | Dr. Alexia Mcclerkin |
First Address | Houston, TX 77054-2402 |
Second Address | Houston, TX 77054-2653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 04/09/2020 |