Provider Demographics
NPI:1003018441
Name:COMFORT CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:COMFORT CHIROPRACTIC, PA
Other - Org Name:COMFORT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-995-3887
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:COMFORT
Mailing Address - State:TX
Mailing Address - Zip Code:78013-0068
Mailing Address - Country:US
Mailing Address - Phone:830-995-3887
Mailing Address - Fax:830-995-3393
Practice Address - Street 1:212 US HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:COMFORT
Practice Address - State:TX
Practice Address - Zip Code:78013-3705
Practice Address - Country:US
Practice Address - Phone:830-995-3887
Practice Address - Fax:830-995-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00607WOtherMEDICARE PTAN
TX07GSOtherBLUE CROSS
TXDC3825OtherRR MEDICARE PTAN