Chirospa Revive

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHIROSPA REVIVE

Practice address

9896 Bissonnet St Ste 133
Houston, TX 77036-8104

Phone

(240) 779-1203

NPI assigned

Jul 24, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Alicia Borne-Nusom, DC

Title

Owner

Phone

(240) 779-1203

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1225681653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 RIO ALAMO ST",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775834002",
            "telephone_number": "240-779-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9896 BISSONNET ST STE 133",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770368104",
            "telephone_number": "240-779-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROSPA REVIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "BORNE-NUSOM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-779-1203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Houston, TX
• Providers in Houston, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.