Provider Demographics
NPI:1043935554
Name:ARCIZO, GERARD FABIAN JR (DC)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:FABIAN
Last Name:ARCIZO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 E AVENUE L
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77012-2848
Mailing Address - Country:US
Mailing Address - Phone:832-283-2128
Mailing Address - Fax:
Practice Address - Street 1:9778 KATY FWY STE 325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1646
Practice Address - Country:US
Practice Address - Phone:713-903-3315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14451111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty