Provider Demographics
NPI:1114232071
Name:KURBAN CHIROPRACTIC HEALTHCARE CLINIC, P.C.
Entity Type:Organization
Organization Name:KURBAN CHIROPRACTIC HEALTHCARE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:ALANE
Authorized Official - Last Name:KURBAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-795-1100
Mailing Address - Street 1:2608 SMITH BARRY RD
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4712
Mailing Address - Country:US
Mailing Address - Phone:817-795-1100
Mailing Address - Fax:817-795-1329
Practice Address - Street 1:2207 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5916
Practice Address - Country:US
Practice Address - Phone:817-795-1100
Practice Address - Fax:817-795-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609284Medicare UPIN