Lake Jackson Chiropractic and Rehab PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12614 Issued in TX

Legal business name

LAKE JACKSON CHIROPRACTIC AND REHAB PC

Practice address

209 Parking Way St
Suite B
Lake Jackson, TX 77566-5226

Phone

(979) 292-8032

Fax

(844) 736-0238

NPI assigned

Apr 4, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert A. Woodard II, D.C.NPI 1134539570

Title

Owner

Phone

(979) 292-8032

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• Robert A Woodard II, D.C.

  • Chiropractor
  • Lake Jackson, TX
  • NPI 1134539570
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689107047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PARKING WAY ST",
            "address_2": "SUITE B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665226",
            "telephone_number": "979-292-8032",
            "fax_number": "844-736-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PARKING WAY ST",
            "address_2": "SUITE B",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665226",
            "telephone_number": "979-292-8032",
            "fax_number": "844-736-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE JACKSON CHIROPRACTIC AND REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-292-8032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "571275",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley D Kweon, O.D.
• Bailey Victoria Laday
• Amy Catherine Laird-Payne, PYSICIAN ASSISTANT
• Lake Jackson Assisted Living, LTD. (Hearthstone at Lake Jackson)
• Lake Jackson Audiology and Hearing Aid Consultants, LLC (Lake Jackson Audiology)
• Lake Jackson Clinic, P.a.
• Lake Jackson Dental Care P.a.
• Lake Jackson Dialysis and Kidney Center, LTD, LLP
• Lake Jackson Emergency Medical Services, Inc.
• Lake Jackson Endoscopy Center, LP.

• Chiropractor in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.