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2211 Fry Rd Ste O, Katy, TX 77449-6233 | |
(832) 321-3452 | |
(833) 746-4523 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Multi-specialty |
Location | 2211 Fry Rd Ste O, Katy, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053821025 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 12889 (Texas) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | John Robert Wyatt |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1982775052 PECOS PAC ID: 5991732117 Enrollment ID: I20050720000102 |
Provider Name | Brian M Riggs |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114101623 PECOS PAC ID: 8123185311 Enrollment ID: I20090313000442 |
Provider Name | Laura Ann Croom |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730522178 PECOS PAC ID: 8123245503 Enrollment ID: I20140807002164 |
Provider Name | Nathan D Gomez |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1174023766 PECOS PAC ID: 8628331691 Enrollment ID: I20180412000034 |
Mailing Address | Practice Location Address |
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2211 Fry Rd Ste O, Katy, TX 77449-6233 Ph: (832) 321-3452 | 2211 Fry Rd Ste O, Katy, TX 77449-6233 Ph: (832) 321-3452 |