Provider Demographics
NPI:1033602347
Name:STROMGREN CHIROPRACTIC OF TEXAS, LLC
Entity Type:Organization
Organization Name:STROMGREN CHIROPRACTIC OF TEXAS, LLC
Other - Org Name:FUNCTIONAL HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:STROMGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-341-4811
Mailing Address - Street 1:5971 VIRGINIA PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5638
Mailing Address - Country:US
Mailing Address - Phone:972-546-0060
Mailing Address - Fax:972-546-0115
Practice Address - Street 1:5971 VIRGINIA PKWY STE 150
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5638
Practice Address - Country:US
Practice Address - Phone:972-546-0060
Practice Address - Fax:972-546-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty