Provider Demographics
NPI:1326115643
Name:AMERICAN CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:AMERICAN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-681-8321
Mailing Address - Street 1:3334 N TOWN EAST BLVD
Mailing Address - Street 2:#102
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3858
Mailing Address - Country:US
Mailing Address - Phone:972-681-8321
Mailing Address - Fax:972-613-8927
Practice Address - Street 1:3334 N TOWN EAST BLVD
Practice Address - Street 2:#102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3858
Practice Address - Country:US
Practice Address - Phone:972-681-8321
Practice Address - Fax:972-613-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G73POtherBLUE CROSS BLUE SHIELD
TX00G73POtherBLUE CROSS BLUE SHIELD