Randi Blackmon Likely, DC | |
17047 El Camino Real Ste 140, Houston, TX 77058-2615 | |
(713) 321-0506 | |
Not Available |
Full Name | Randi Blackmon Likely |
---|---|
Gender | Female |
Speciality | Chiropractor |
Location | 17047 El Camino Real Ste 140, Houston, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528701166 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 15153 (Texas) | Primary |
Provider Name | Backed By Blackmon |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1306580584 PECOS PAC ID: 6507232949 Enrollment ID: O20221026001435 |
Mailing Address | Practice Location Address |
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Randi Blackmon Likely, DC 2578 Madison Ave, League City, TX 77573-4566 Ph: () - | Randi Blackmon Likely, DC 17047 El Camino Real Ste 140, Houston, TX 77058-2615 Ph: (713) 321-0506 |
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