Provider Demographics
NPI:1679586358
Name:MCCOMB, MARCUS CODY (DC)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:CODY
Last Name:MCCOMB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1110 KINGWOOD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3001
Mailing Address - Country:US
Mailing Address - Phone:281-359-6932
Mailing Address - Fax:281-359-2647
Practice Address - Street 1:1110 KINGWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3001
Practice Address - Country:US
Practice Address - Phone:281-359-6932
Practice Address - Fax:281-359-2647
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C0828Medicare ID - Type Unspecified