Provider Demographics
NPI:1598153967
Name:PARADIGM TRANSFORMATIONS
Entity Type:Organization
Organization Name:PARADIGM TRANSFORMATIONS
Other - Org Name:3D HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:MACIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-764-0405
Mailing Address - Street 1:16410 BLANCO RD STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1915
Mailing Address - Country:US
Mailing Address - Phone:210-764-0405
Mailing Address - Fax:
Practice Address - Street 1:16410 BLANCO RD STE 5
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1915
Practice Address - Country:US
Practice Address - Phone:210-764-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty