Provider Demographics
NPI:1164179818
Name:PREMIER CHIRO MED PLLC
Entity Type:Organization
Organization Name:PREMIER CHIRO MED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSNI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:877-515-3336
Mailing Address - Street 1:9669 N CENTRAL EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5054
Mailing Address - Country:US
Mailing Address - Phone:214-265-9000
Mailing Address - Fax:214-696-1757
Practice Address - Street 1:9669 N CENTRAL EXPY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5054
Practice Address - Country:US
Practice Address - Phone:214-265-9000
Practice Address - Fax:214-696-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty