Provider Demographics
NPI:1003363011
Name:WEIR FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:WEIR FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-242-6886
Mailing Address - Street 1:1108 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006
Mailing Address - Country:US
Mailing Address - Phone:214-529-0871
Mailing Address - Fax:972-242-7886
Practice Address - Street 1:1108 S ELM ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-7226
Practice Address - Country:US
Practice Address - Phone:972-242-6886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1053746313Medicare PIN