Provider Demographics
NPI:1346327780
Name:CHIROPRACTIC NEUROLOGY CENTER, PC
Entity Type:Organization
Organization Name:CHIROPRACTIC NEUROLOGY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:940-325-0077
Mailing Address - Street 1:112 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-5341
Mailing Address - Country:US
Mailing Address - Phone:940-325-0077
Mailing Address - Fax:
Practice Address - Street 1:112 SE 4TH AVE
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-5341
Practice Address - Country:US
Practice Address - Phone:940-325-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A2260OtherBCBS PROVIDER ID
TX8A2260OtherBCBS PROVIDER ID
TX605061Medicare PIN