1P410 Sports Performance
Organization Active NPI Sports Physician Chiropractor · The Woodlands, TX
NPI 1588070528 · NPPES record last updated Jul 10, 2014
Key facts
- NPI
- 1588070528
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Physician Chiropractor 111NS0005X
- License
- 12247 (TX)
- Legal business name
- 1P410 SPORTS PERFORMANCE
- Practice address
- 7 Player Grove CT
The Woodlands, TX 77382-2124 - Phone
- (832) 791-5954
- NPI assigned
- Jul 10, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Derrick Raymer, D.C.
- Title
- Director of Sports Performance
- Phone
- (832) 791-5954
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor |
111NS0005X | 12247 | TX | Yes |
Addresses
Primary practice location
7 Player Grove CT
The Woodlands, TX 77382-2124
Mailing address
7 Player Grove CT
The Woodlands, TX 77382-2124
Other names
- Athletic Republic-The Woodlands
Other providers in The Woodlands, TX
- 100 Chiro Livingood Woodlands PLLC
- 10700 W Montfair Blvd, LLC
- 1960 Family Practice, PA
- 4K Care
- 911 First Surgical Assistant
- Jonathan Abay
- Ahmad F. Abbas
- Elham Abbasi-Hafshejani
All providers in The Woodlands, TX · Sports Physician Chiropractor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.