Doctor Name: | DR. ANDREW KUBOSUMI |
NPI Number: | 1922490978 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 12777 |
Business Practice Address: | 1220 N Town East Blvd Suite 250 Mesquite, TX - 751507605 |
Business Phone Number: | 9722795300 |
Business Fax Number: | 9722795303 |
Mailing Address: | 1220 N Town East Blvd, Suite 250 MESQUITE |
State: | TX |
Postal Code: | 751507605 |
Phone Number: | 9722795300 |
Fax Number: | 9722795303 |
NPI Enumeration Date: | 02/28/2015 |
NPI Last Update Date: | 02/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 12777 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |