Provider Demographics
NPI:1063839181
Name:S. R. HEALTHCARE
Entity Type:Organization
Organization Name:S. R. HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-307-1260
Mailing Address - Street 1:7420 REMCON CIR
Mailing Address - Street 2:C-3
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3529
Mailing Address - Country:US
Mailing Address - Phone:915-587-4600
Mailing Address - Fax:915-581-6324
Practice Address - Street 1:7420 REMCON CIR
Practice Address - Street 2:C-3
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3529
Practice Address - Country:US
Practice Address - Phone:915-587-4600
Practice Address - Fax:915-581-6324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty