Provider Demographics
NPI:1376660092
Name:FILLA ENTERPRISES, INC.
Entity Type:Organization
Organization Name:FILLA ENTERPRISES, INC.
Other - Org Name:FILLA CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:FILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-387-1716
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-0647
Mailing Address - Country:US
Mailing Address - Phone:361-387-1716
Mailing Address - Fax:361-387-2599
Practice Address - Street 1:800 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-3135
Practice Address - Country:US
Practice Address - Phone:361-387-1716
Practice Address - Fax:361-387-2599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8444111N00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5803830001Medicare NSC
TX00927UMedicare PIN