Provider Demographics
NPI:1417140476
Name:DIAGNOSTIC CHIROPRACTIC CENTER OF THE SOUTHWEST, INC.
Entity Type:Organization
Organization Name:DIAGNOSTIC CHIROPRACTIC CENTER OF THE SOUTHWEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:956-544-0322
Mailing Address - Street 1:2501 PAREDES LINE RD
Mailing Address - Street 2:SUITE B1
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1193
Mailing Address - Country:US
Mailing Address - Phone:956-544-0322
Mailing Address - Fax:956-982-4229
Practice Address - Street 1:2501 PAREDES LINE RD
Practice Address - Street 2:SUITE B1
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-1193
Practice Address - Country:US
Practice Address - Phone:956-544-0322
Practice Address - Fax:956-982-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty