Provider Demographics
NPI:1497971766
Name:BACK AND BODY PC
Entity Type:Organization
Organization Name:BACK AND BODY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SYMMANK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-596-2811
Mailing Address - Street 1:5100 ELDORADO PKWY
Mailing Address - Street 2:SUITE 102 PMB 803
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2995 PRESTON RD
Practice Address - Street 2:SUITE 1550
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0602
Practice Address - Country:US
Practice Address - Phone:214-596-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC9044261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015KKOtherBCBS
TX0015KKOtherBCBS