Provider Demographics
NPI:1518390921
Name:KURTH CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:KURTH CHIROPRACTIC INC.
Other - Org Name:BENBROOK FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-521-8284
Mailing Address - Street 1:1008 WINSCOTT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-2778
Mailing Address - Country:US
Mailing Address - Phone:817-249-8888
Mailing Address - Fax:817-249-4098
Practice Address - Street 1:1008 WINSCOTT RD
Practice Address - Street 2:SUITE A
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-2778
Practice Address - Country:US
Practice Address - Phone:817-249-8888
Practice Address - Fax:817-249-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318491Medicare PIN