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Organization

SPADE CHRIPORACTIC PHYSICAL MEDICINE & DIAGNOSTIC CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LLORD OBINNA NWOSU (DIRECTOR)
(713) 777-1734
Entity
Organization

Contact information

Practice address
9207 COUNTRY CREEK DR, SUITE 111, HOUSTON, TX 77036-7714
(713) 777-1734
Mailing address
9207 CLUB CREEK, SUITE 111, HOUSTON, TX 77036-7745
(713) 777-1734

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NA
TX
Enumeration date
06/15/2010
Last updated
06/15/2010
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