Provider Demographics
NPI:1578760617
Name:INJURY CARE ASSOCIATES PA
Entity Type:Organization
Organization Name:INJURY CARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAIVAN-MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-701-8181
Mailing Address - Street 1:PO BOX 542581
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75354-2581
Mailing Address - Country:US
Mailing Address - Phone:972-701-8181
Mailing Address - Fax:972-701-8182
Practice Address - Street 1:6161 HARRY HINES BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5387
Practice Address - Country:US
Practice Address - Phone:972-701-8181
Practice Address - Fax:972-701-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9504111N00000X
TX9455111N00000X
TXJ3024207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty