Provider Demographics
NPI:1164546792
Name:ACCIDENT INDUSTRIAL INJURY CARE CENTER
Entity Type:Organization
Organization Name:ACCIDENT INDUSTRIAL INJURY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-633-8150
Mailing Address - Street 1:1360 N LEE TREVINO DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6400
Mailing Address - Country:US
Mailing Address - Phone:915-633-8150
Mailing Address - Fax:915-633-8140
Practice Address - Street 1:1360 N LEE TREVINO DR
Practice Address - Street 2:SUITE 109
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6400
Practice Address - Country:US
Practice Address - Phone:915-633-8150
Practice Address - Fax:915-633-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A7930OtherBCBS PROVIDER #
TXP00060668OtherBCBS RR PROVIDER #
TX8A7930OtherBCBS PROVIDER #