Provider Demographics
NPI:1235208067
Name:KLESMIT CHIROPRACTIC OFFICES, P.A.
Entity Type:Organization
Organization Name:KLESMIT CHIROPRACTIC OFFICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:KLESMIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-771-1255
Mailing Address - Street 1:809 EAGLE PASS
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5929
Mailing Address - Country:US
Mailing Address - Phone:972-771-1255
Mailing Address - Fax:972-772-4569
Practice Address - Street 1:809 EAGLE PASS
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-5929
Practice Address - Country:US
Practice Address - Phone:972-771-1255
Practice Address - Fax:972-772-4569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4349261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y093Medicare PIN