Provider Demographics
NPI:1275718579
Name:UPTOWN CHIROPRACTIC
Entity Type:Organization
Organization Name:UPTOWN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUERBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-979-9013
Mailing Address - Street 1:2909 COLE AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1189
Mailing Address - Country:US
Mailing Address - Phone:214-979-9013
Mailing Address - Fax:214-979-9014
Practice Address - Street 1:2909 COLE AVE
Practice Address - Street 2:STE 205
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1189
Practice Address - Country:US
Practice Address - Phone:214-979-9013
Practice Address - Fax:214-979-9014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K6050OtherBC BS OF TEXAS