Provider Demographics
NPI:1578707618
Name:FAMILY WELLNESS CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:FAMILY WELLNESS CHIROPRACTIC CENTER, INC.
Other - Org Name:FAMILY WELLNESS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-437-4944
Mailing Address - Street 1:1702 N COLLINS BLVD
Mailing Address - Street 2:SUITE 161
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3566
Mailing Address - Country:US
Mailing Address - Phone:972-437-4944
Mailing Address - Fax:972-437-0534
Practice Address - Street 1:1702 N COLLINS BLVD
Practice Address - Street 2:SUITE 161
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3566
Practice Address - Country:US
Practice Address - Phone:972-437-4944
Practice Address - Fax:972-437-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605802OtherBCBS
U70071Medicare UPIN
TX609047Medicare PIN