Provider Demographics
NPI:1053628750
Name:CARY P. DAN, P.C.
Entity Type:Organization
Organization Name:CARY P. DAN, P.C.
Other - Org Name:CHIROPRACTIC OF MIDDLE IRVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-251-1110
Mailing Address - Street 1:3200 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4404
Mailing Address - Country:US
Mailing Address - Phone:972-251-1110
Mailing Address - Fax:972-258-1945
Practice Address - Street 1:3200 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4404
Practice Address - Country:US
Practice Address - Phone:972-251-1110
Practice Address - Fax:972-258-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00110661Medicaid
TX600976OtherBLUE CROSS BLUE SHIELD
TX00110661Medicaid
TX600976OtherBLUE CROSS BLUE SHIELD