Provider Demographics
NPI:1164793493
Name:TRINITY CHIROPRACTIC OF BURLESON PC
Entity Type:Organization
Organization Name:TRINITY CHIROPRACTIC OF BURLESON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CHASE
Authorized Official - Last Name:DYESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-839-0920
Mailing Address - Street 1:815 SW ALSBURY BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4095
Mailing Address - Country:US
Mailing Address - Phone:972-839-0920
Mailing Address - Fax:
Practice Address - Street 1:815 SW ALSBURY BLVD
Practice Address - Street 2:STE 3
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4095
Practice Address - Country:US
Practice Address - Phone:972-839-0920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty