Organization Active NPI

Memorial Chiropractic Clinic, Inc

  • Chiropractor
  • Houston, TX
National Provider Identifier
1124270798
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MEMORIAL CHIROPRACTIC CLINIC, INC
Practice address
12421 Memorial Dr
Houston, TX 77024-6131
Phone
(713) 467-5367
Fax
(713) 467-0937
NPI assigned
Oct 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jack Christie, D.C.
Title
Owner
Phone
(713) 467-5367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

12421 Memorial Dr
Houston, TX 77024-6131

Mailing address

12421 Memorial Dr
Houston, TX 77024-6131
Phone (713) 467-5367

Other identifiers 1

IdentifierTypeStateIssuer
31EMOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140922000258 TX Part B Supplier - Clinic/Group Practice 7618196890 Receives reassigned benefits from 4 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

12421 Memorial Dr
Houston, TX 77024
Phone (713) 467-5367

815 Walker St
Ste T22
Houston, TX 77002
Phone (713) 222-6000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1124270798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770246131",
            "telephone_number": "713-467-5367",
            "fax_number": "713-467-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770246131",
            "telephone_number": "713-467-5367",
            "fax_number": "713-467-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "CHRISTIE",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-467-5367",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31EM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.