Provider Demographics
NPI:1205023793
Name:CAN HO ENTERPRISE
Entity Type:Organization
Organization Name:CAN HO ENTERPRISE
Other - Org Name:MEDCARE HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:CAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-870-2005
Mailing Address - Street 1:613 NORTH FWY
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-1726
Mailing Address - Country:US
Mailing Address - Phone:817-870-2005
Mailing Address - Fax:817-870-3667
Practice Address - Street 1:613 NORTH FWY
Practice Address - Street 2:SUITE 116
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-1726
Practice Address - Country:US
Practice Address - Phone:817-870-2005
Practice Address - Fax:817-870-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8322OtherBCBS
TX8B8322OtherBCBS