Provider Demographics
NPI:1114109980
Name:TRICARE CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:TRICARE CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:TRINH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-987-4150
Mailing Address - Street 1:3612 MATLOCK RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3680
Mailing Address - Country:US
Mailing Address - Phone:817-987-4150
Mailing Address - Fax:817-987-4151
Practice Address - Street 1:3612 MATLOCK RD STE 105
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3680
Practice Address - Country:US
Practice Address - Phone:817-987-4150
Practice Address - Fax:817-987-4151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRICARE CHIROPRACTIC, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXX91409Medicare UPIN
TX8A7619Medicare PIN