Provider Demographics
NPI:1235658279
Name:SIA CHIROPRACTIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:SIA CHIROPRACTIC ASSOCIATES LLC
Other - Org Name:METRO SPINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-796-3342
Mailing Address - Street 1:2409 ALCO AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-2614
Mailing Address - Country:US
Mailing Address - Phone:214-613-1995
Mailing Address - Fax:214-613-1078
Practice Address - Street 1:2409 ALCO AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2614
Practice Address - Country:US
Practice Address - Phone:214-613-1995
Practice Address - Fax:214-613-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10096111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty