Provider Demographics
NPI:1366453821
Name:JENSEN DIAGNOSTIC & TREATMENT CENTER
Entity Type:Organization
Organization Name:JENSEN DIAGNOSTIC & TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-243-5757
Mailing Address - Street 1:13714 GAMMA ROAD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4485
Mailing Address - Country:US
Mailing Address - Phone:972-243-5757
Mailing Address - Fax:972-488-6988
Practice Address - Street 1:13714 GAMMA RD
Practice Address - Street 2:SUITE 125
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-4474
Practice Address - Country:US
Practice Address - Phone:972-243-5757
Practice Address - Fax:972-488-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty