Provider Demographics
NPI:1255662029
Name:PERSISTENT HEALTH PA
Entity Type:Organization
Organization Name:PERSISTENT HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JURE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARENIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-455-2122
Mailing Address - Street 1:4110 FM 407 STE 200
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7269
Mailing Address - Country:US
Mailing Address - Phone:940-455-2122
Mailing Address - Fax:940-455-7359
Practice Address - Street 1:4110 FM 407 STE 200
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-7269
Practice Address - Country:US
Practice Address - Phone:940-455-2122
Practice Address - Fax:940-455-7359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty