Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8329 | TX |
N | 111NX0100X | Occupational Health | 8329 | TX |
NPI | 1730378654 |
---|---|
Provider Name | Dr. Derrick Stenson |
First Address | Houston, TX 77074-2931 |
Second Address | Houston, TX 77074-2931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 28/05/2014 |