DR. JAY MANGUM (NPI# 1699127159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699127159 |
| Entity Type | Individual |
| Full Name | DR. JAY MANGUM |
| Credential | DC |
| Practice Address |
21770 Kingsland Blvd Katy TX 77450-2513 |
| Mailing Address |
Po Box 700688 San Antonio TX 78270-0688 |
| Practice Telephone | 8004046050 |
| Practice Fax Number | 8663133397 |
| Mailing Telephone | 2104777654 |
| Mailing Fax Number | 2104680682 |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2019-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 13577 | TX | Chiropractic Providers |
| N | 111N00000X | Chiropractor | CHIA-1725 | ID | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS BOARD OF CHIROPRACTIC EXAMINERS | 13577 | 01 |
| Street Address |
21770 KINGSLAND BLVD |
| City | KATY |
| State | TX |
| Zip Code | 77450-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033205224 | Quyen Trinh | Family Medicine | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2006-10-05 |
| 1710480298 | Elizabeth Pruett | Nurse Practitioner | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2018-03-12 |
| 1598265886 | Saba Zabarah | Registered Nurse | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2018-02-13 |
| 1124568225 | Jenny Phan | Physician Assistant | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2017-03-08 |
| 1730562190 | Shannon Nicole Gibson | Physician Assistant | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2015-07-02 |
| 1558791798 | Innovus Health, Pllc | Orthopaedic Surgery | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2013-11-26 |
| 1053592949 | Trang Thuy Trinh, Md, Pa | Family Medicine | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2007-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639652555 | O'brien Counseling Services, Inc. | Counselor | 21368 Provincial Blvd., Katy, TX 77450 | 2018-09-07 |
| 1306327275 | Renova Wellness Clinic | Counselor | 468 Park Grove Ln, Katy, TX 77450 | 2018-08-28 |
| 1639661556 | Health Care Senior Pllc | Family Medicine | 21702 Balsam Brook Ln, Katy, TX 77450 | 2018-06-06 |
| 1679081012 | Mason Sleep & Diagnostics | Clinic/Center | 462 S Mason Rd, Suite 400, Katy, TX 77450 | 2018-01-19 |
| 1508379900 | Mason Diagnostic Imaging | Clinic/Center | 462 S Mason Road, Suite 400, Katy, TX 77450 | 2017-11-08 |
| 1376055384 | Stella Dental Vk Pllc | Dentist | 21040 Highland Knolls Drive, Suite 100, Katy, TX 77450 | 2017-10-31 |
| 1598286031 | Ammon Zukeran Dc Inc | Chiropractor | 416 Park Grove Ln, Katy, TX 77450 | 2017-07-06 |
| 1588191571 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 777 S Fry Rd Ste 208, Katy, TX 77450 | 2017-05-22 |
| 1629527395 | Christine Margaret Gholston | Counselor | 472 Park Grove, Katy, TX 77450 | 2016-09-23 |
| 1598213928 | Kristina Reyes | Counselor | 633 E. Fernhust Dr., Ste 501, Katy, TX 77450 | 2016-09-14 |
| Find all providers in zip 77450 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916298 | Thrive Katy Chiropractic LLC | Chiropractor | 25830 Westheimer Pkwy Ste 700, Katy, TX 77494-5377 | 2020-09-14 |
| 1578182432 | Christian William Marshall | Chiropractor | 1922 Pontius Dr, Katy, TX 77493-2753 | 2020-04-10 |
| 1851922413 | Chloe Tong | Chiropractor | 215 Leyden Ct, Katy, TX 77450-2111 | 2020-01-31 |
| 1497393870 | Carmen Danielle Doerr-nauth | Chiropractor | 23221 Red River Dr, Katy, TX 77494-2031 | 2019-12-16 |
| 1922645332 | Momentum Regenerative Medicine Pllc | Chiropractor | 2770 Fm 1463 Rd Ste 101b, Katy, TX 77494-7968 | 2019-12-04 |
| 1558915645 | Tn Mobile Chiropractic LLC | Chiropractor | 22101 Morton Ranch Rd, Katy, TX 77449-7819 | 2019-07-28 |
| 1265990527 | Legros Chiropractic & Rehab, Pllc | Chiropractor | 21927 Clay Rd, Suite 700, Katy, TX 77449 | 2019-03-06 |
| 1871057547 | Kimberlee Barnhart | Chiropractor | 5803 2nd St Ste 2, Katy, TX 77493-2781 | 2019-01-28 |
| 1841783263 | Logan Drew Snyder | Chiropractor | 21322a Provincial Blvd, Katy, TX 77450-7580 | 2018-06-11 |
| 1174023766 | Nathan Gomez | Chiropractor | 2211 Fry Rd Ste M, Katy, TX 77449-6233 | 2018-02-20 |
| Find all providers in KATY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.