Provider Demographics
NPI:1093880056
Name:CANUSA ENTERPRISE
Entity Type:Organization
Organization Name:CANUSA ENTERPRISE
Other - Org Name:NORTH TEXAS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JURE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARENIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-966-6996
Mailing Address - Street 1:1940 WEST FM 407
Mailing Address - Street 2:STE 110
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2152
Mailing Address - Country:US
Mailing Address - Phone:972-966-6996
Mailing Address - Fax:972-966-6966
Practice Address - Street 1:1940 WEST FM 407
Practice Address - Street 2:STE 110
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-2152
Practice Address - Country:US
Practice Address - Phone:972-966-6996
Practice Address - Fax:972-966-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9028111N00000X
TX9031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609713Medicare PIN