Provider Demographics
NPI:1164779492
Name:ARTEVA, LLC
Entity Type:Organization
Organization Name:ARTEVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:469-323-8739
Mailing Address - Street 1:2021 JUSTIN RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3800
Mailing Address - Country:US
Mailing Address - Phone:972-539-2446
Mailing Address - Fax:972-539-2066
Practice Address - Street 1:2021 JUSTIN RD
Practice Address - Street 2:SUITE 132
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3800
Practice Address - Country:US
Practice Address - Phone:972-539-2446
Practice Address - Fax:972-539-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty