Provider Demographics
NPI:1487848172
Name:METROPLEX ADVANCED HEALTHCARE INC.
Entity Type:Organization
Organization Name:METROPLEX ADVANCED HEALTHCARE INC.
Other - Org Name:ADVANCED CHIROPRACTIC & SPORTS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CONNORS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-428-7246
Mailing Address - Street 1:1304 GLADE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4284
Mailing Address - Country:US
Mailing Address - Phone:817-428-7246
Mailing Address - Fax:817-428-4436
Practice Address - Street 1:1304 GLADE RD STE 200
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-4284
Practice Address - Country:US
Practice Address - Phone:817-428-7246
Practice Address - Fax:817-428-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU63456Medicare UPIN