Provider Demographics
NPI:1073933842
Name:PRAMUKH NO MARG LLC
Entity Type:Organization
Organization Name:PRAMUKH NO MARG LLC
Other - Org Name:HEALTHSOURCE OF COLLEYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SHASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-476-1665
Mailing Address - Street 1:6735 PLAZA VIA
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3224
Mailing Address - Country:US
Mailing Address - Phone:214-476-1665
Mailing Address - Fax:
Practice Address - Street 1:6735 PLAZA VIA
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3224
Practice Address - Country:US
Practice Address - Phone:214-476-1665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty