Provider Demographics
NPI:1578835633
Name:DR CAMERON ROE P.L.L.C.
Entity Type:Organization
Organization Name:DR CAMERON ROE P.L.L.C.
Other - Org Name:ANNA CHIROPRACTIC CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:INSURANCE AND BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TARANGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-924-2286
Mailing Address - Street 1:100 S POWELL PKWY
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-3599
Mailing Address - Country:US
Mailing Address - Phone:972-924-2286
Mailing Address - Fax:972-924-4688
Practice Address - Street 1:2100 W WHITE ST STE 230
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-5516
Practice Address - Country:US
Practice Address - Phone:972-924-2286
Practice Address - Fax:972-924-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613063OtherMEDICARE PTAN