Provider Demographics
NPI:1508125238
Name:MUA ASSOCIATES OF NORTH TEXAS
Entity Type:Organization
Organization Name:MUA ASSOCIATES OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARJONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-815-5943
Mailing Address - Street 1:114 FIELDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6890
Mailing Address - Country:US
Mailing Address - Phone:214-815-5943
Mailing Address - Fax:
Practice Address - Street 1:114 FIELDWOOD CT
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-6890
Practice Address - Country:US
Practice Address - Phone:214-815-5943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty