Provider Demographics
NPI:1497144547
Name:SURACE, JOSEPH VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:VINCENT
Last Name:SURACE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13140 COIT RD
Mailing Address - Street 2:SUITE 514
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5755
Mailing Address - Country:US
Mailing Address - Phone:972-925-0384
Mailing Address - Fax:972-925-9163
Practice Address - Street 1:13140 COIT RD
Practice Address - Street 2:SUITE 514
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5755
Practice Address - Country:US
Practice Address - Phone:972-925-0384
Practice Address - Fax:972-925-9163
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor