Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 10809 | TX |
Y | 111NS0005X | Chiropractic Sports Physician | 4340 | TX |
NPI | 1285803874 |
---|---|
Provider Name | Dr. William Barton Kennedy JR. |
First Address | Houston, TX 77079-7518 |
Second Address | Houston, TX 77079-7518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 27/02/2008 |