Provider Demographics
NPI:1326330523
Name:RENSHAW CHIROPRACTIC
Entity Type:Organization
Organization Name:RENSHAW CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:RENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-542-8100
Mailing Address - Street 1:2770 VIRGINIA PKWY
Mailing Address - Street 2:401
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5082
Mailing Address - Country:US
Mailing Address - Phone:972-542-8100
Mailing Address - Fax:972-542-8101
Practice Address - Street 1:2770 VIRGINIA PKWY
Practice Address - Street 2:401
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5082
Practice Address - Country:US
Practice Address - Phone:972-542-8100
Practice Address - Fax:972-542-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty