Provider Demographics
NPI:1275715807
Name:BRADY CHIROPRACTIC
Entity Type:Organization
Organization Name:BRADY CHIROPRACTIC
Other - Org Name:ALTERNATIVE PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-867-8500
Mailing Address - Street 1:2929 CUSTER RD
Mailing Address - Street 2:#320
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4418
Mailing Address - Country:US
Mailing Address - Phone:972-867-8500
Mailing Address - Fax:972-867-8509
Practice Address - Street 1:2929 CUSTER RD
Practice Address - Street 2:#320
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4418
Practice Address - Country:US
Practice Address - Phone:972-867-8500
Practice Address - Fax:972-867-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9694111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1649383233OtherNPI TYPE 1