Provider Demographics
NPI:1487673364
Name:LOVING CARE CHIROPRACTIC
Entity Type:Organization
Organization Name:LOVING CARE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:POLASEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-270-9200
Mailing Address - Street 1:2944 MOTLEY DR
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3460
Mailing Address - Country:US
Mailing Address - Phone:972-270-9200
Mailing Address - Fax:972-270-9202
Practice Address - Street 1:2944 MOTLEY DR
Practice Address - Street 2:SUITE 314
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3460
Practice Address - Country:US
Practice Address - Phone:972-270-9200
Practice Address - Fax:972-270-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC9371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0062QDOtherBLUE CROSS BLUE SHIELD OF