Willis Spine & Rehabilitation

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10274 Issued in TX

Legal business name

WILLIS SPINE & REHABILITATION

Practice address

804 W Montgomery St
Suite a
Willis, TX 77378-8830

Phone

(936) 856-8908

Fax

(936) 856-8022

NPI assigned

Dec 13, 2011

Organization subpart

No

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

Authorized official

Name

Todd R Custer, D.C., A.T.C.NPI 1043245574

Title

Owner/Doctor

Phone

(936) 856-8908

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Todd Robert Custer, D.C.

  • Chiropractor
  • Willis, TX
  • NPI 1043245574
  NPD (past) Authorized official

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1316215718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 W MONTGOMERY ST",
            "address_2": "SUITE A",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773788830",
            "telephone_number": "936-856-8908",
            "fax_number": "936-856-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 W MONTGOMERY ST",
            "address_2": "SUITE A",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773788830",
            "telephone_number": "936-856-8908",
            "fax_number": "936-856-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS SPINE & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "CUSTER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "936-856-8908",
        "authorized_official_credential": "D.C., A.T.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Williams
• Willis Family Dental Care PLLC
• Willis Isd
• Willis Nursing and Rehabilitation LP
• Willis Pediatric Dentistry
• Willis Surgicenter, LLC (Willis Surgery Center)
• Weiwei Wu, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.