Provider Demographics
NPI:1417142241
Name:WEST TEXAS CHIROPRACTIC CENTER L.L.C.
Entity Type:Organization
Organization Name:WEST TEXAS CHIROPRACTIC CENTER L.L.C.
Other - Org Name:WEST TEXAS CHIROPRACTIC CENTER L.L.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-562-5700
Mailing Address - Street 1:4530 MONTANA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4700
Mailing Address - Country:US
Mailing Address - Phone:915-562-5700
Mailing Address - Fax:915-562-5703
Practice Address - Street 1:4530 MONTANA AVE STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4700
Practice Address - Country:US
Practice Address - Phone:915-562-5700
Practice Address - Fax:915-562-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF007876261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center