Provider Demographics
NPI:1033586607
Name:TEXAS HEALTH REALIGNMENT CENTER LLC
Entity Type:Organization
Organization Name:TEXAS HEALTH REALIGNMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LEZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-221-1000
Mailing Address - Street 1:2680 DENTON TAP RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8210
Mailing Address - Country:US
Mailing Address - Phone:972-221-1000
Mailing Address - Fax:972-221-1001
Practice Address - Street 1:2680 DENTON TAP RD
Practice Address - Street 2:SUITE 111
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8210
Practice Address - Country:US
Practice Address - Phone:972-221-1000
Practice Address - Fax:972-221-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-29
Last Update Date:2015-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty