Provider Demographics
NPI:1083919732
Name:WORK ACCIDENT CENTER
Entity Type:Organization
Organization Name:WORK ACCIDENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-888-8889
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78403-0579
Mailing Address - Country:US
Mailing Address - Phone:361-888-8889
Mailing Address - Fax:361-888-8887
Practice Address - Street 1:1231 AGNES ST
Practice Address - Street 2:SUITE A-1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3272
Practice Address - Country:US
Practice Address - Phone:361-888-8889
Practice Address - Fax:361-888-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty