Provider Demographics
NPI:1356851802
Name:RICHARDSON INTEGRATED HEALTH
Entity Type:Organization
Organization Name:RICHARDSON INTEGRATED HEALTH
Other - Org Name:RICHARDSON PAIN AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZINOVY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-907-2800
Mailing Address - Street 1:777 S CENTRAL EXPY STE 6D
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7421
Mailing Address - Country:US
Mailing Address - Phone:972-907-2800
Mailing Address - Fax:
Practice Address - Street 1:777 S CENTRAL EXPY STE 6D
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7421
Practice Address - Country:US
Practice Address - Phone:972-907-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty