Provider Demographics
NPI:1265442156
Name:ASSOCIATED CHIROPRACTIC PROFESSIONALS, P.A.
Entity Type:Organization
Organization Name:ASSOCIATED CHIROPRACTIC PROFESSIONALS, P.A.
Other - Org Name:WOODWARD CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-490-9888
Mailing Address - Street 1:6310 LYNDON B JOHNSON FWY STE 115
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6424
Mailing Address - Country:US
Mailing Address - Phone:972-490-8888
Mailing Address - Fax:972-490-9830
Practice Address - Street 1:6310 LYNDON B JOHNSON FWY STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6424
Practice Address - Country:US
Practice Address - Phone:972-490-9888
Practice Address - Fax:972-490-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
246409OtherPHCS
0014HSOtherBCBS GROUP ID
TX173959101Medicaid
00468UMedicare ID - Type UnspecifiedGROUP ID