Provider Demographics
NPI:1255650156
Name:BACK AND NECK CARE OF ARLINGTON
Entity Type:Organization
Organization Name:BACK AND NECK CARE OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:AWWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-275-9249
Mailing Address - Street 1:PO BOX 151482
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-7482
Mailing Address - Country:US
Mailing Address - Phone:817-275-9249
Mailing Address - Fax:817-275-9273
Practice Address - Street 1:1144 W PIONEER PKWY
Practice Address - Street 2:SUITE H
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6389
Practice Address - Country:US
Practice Address - Phone:817-275-9249
Practice Address - Fax:817-275-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
606225OtherBLUE CROSS BLUE SHIELD
606225OtherBLUE CROSS BLUE SHIELD