Provider Demographics
NPI:1497953988
Name:DAVID BACK CLINIC OF AMERICA
Entity Type:Organization
Organization Name:DAVID BACK CLINIC OF AMERICA
Other - Org Name:DBC FT. WORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER -VP NATIONAL DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLINKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-839-3250
Mailing Address - Street 1:3800 HULEN ST
Mailing Address - Street 2:#110
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7276
Mailing Address - Country:US
Mailing Address - Phone:817-921-9983
Mailing Address - Fax:817-763-9985
Practice Address - Street 1:3800 HULEN ST
Practice Address - Street 2:#110
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7276
Practice Address - Country:US
Practice Address - Phone:817-921-9983
Practice Address - Fax:817-763-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6117207L00000X
2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty