Provider Demographics
NPI:1114119476
Name:DYNACARE MEDICAL & CHIROPRACTIC
Entity Type:Organization
Organization Name:DYNACARE MEDICAL & CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:EMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-771-0261
Mailing Address - Street 1:6300 HILLCROFT #490
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081
Mailing Address - Country:US
Mailing Address - Phone:713-771-0261
Mailing Address - Fax:
Practice Address - Street 1:6300 HILLCROFT ST STE 490
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3008
Practice Address - Country:US
Practice Address - Phone:713-771-0261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8810305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization