Organization
WASHINGTON AVE DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAIME BONILLA (ADM)
(713) 802-9188
Entity
Organization
Contact information
Practice address
2510 WASHINGTON AVE, HOUSTON, TX 77007-6021
(713) 802-9188
(713) 802-2278
Mailing address
2510 WASHINGTON AVE, HOUSTON, TX 77007-6021
(713) 802-9188
(713) 802-2278
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
10580
TX
261Q00000X
Clinic/Center
Primary
0J63X
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091859103
—
TX
Enumeration date
08/31/2006
Last updated
06/03/2009
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