Provider Demographics
NPI:1275615247
Name:CHIROPRACTIC HEALTHCARE CENTER
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-294-1346
Mailing Address - Street 1:8680 MAIN STREET
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-335-2004
Mailing Address - Fax:972-335-2037
Practice Address - Street 1:8680 MAIN STREET
Practice Address - Street 2:SUITE 3E
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-335-2004
Practice Address - Fax:972-335-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P6027OtherBC BS
TX8F1050Medicare ID - Type Unspecified
TX8P6027OtherBC BS