Provider Demographics
NPI:1558808790
Name:TEXAS INJURY & WELLNESS CLINIC LLC
Entity Type:Organization
Organization Name:TEXAS INJURY & WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-413-8090
Mailing Address - Street 1:PO BOX 172711
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76003-2711
Mailing Address - Country:US
Mailing Address - Phone:972-413-8090
Mailing Address - Fax:
Practice Address - Street 1:11751 ALTA VISTA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6441
Practice Address - Country:US
Practice Address - Phone:972-413-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13145111N00000X
TX13140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty