Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 12635 | TX |
NPI | 1245641125 |
---|---|
Provider Name | Joseph Urrea |
First Address | Houston, TX 77058-1145 |
Second Address | Houston, TX 77058-1145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2014 |
Last Update Date | 14/05/2014 |