Provider Demographics
NPI:1417176975
Name:WARD CHIROPRACTIC
Entity Type:Organization
Organization Name:WARD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-351-4070
Mailing Address - Street 1:3530 FOREST LN STE 50
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4161
Mailing Address - Country:US
Mailing Address - Phone:214-351-4070
Mailing Address - Fax:214-352-4074
Practice Address - Street 1:3530 FOREST LN STE 50
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-4161
Practice Address - Country:US
Practice Address - Phone:214-351-4070
Practice Address - Fax:214-352-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609689Medicare ID - Type Unspecified
TXU88297Medicare UPIN