Provider Demographics
NPI:1598985004
Name:DR. SUZAN J. SMITH CHIROPRACTIC PA
Entity Type:Organization
Organization Name:DR. SUZAN J. SMITH CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-245-3377
Mailing Address - Street 1:3044 OLD DENTON RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5016
Mailing Address - Country:US
Mailing Address - Phone:972-245-3377
Mailing Address - Fax:972-245-6366
Practice Address - Street 1:3044 OLD DENTON RD
Practice Address - Street 2:SUITE 316
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5016
Practice Address - Country:US
Practice Address - Phone:972-245-3377
Practice Address - Fax:972-245-6366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0071KZOtherBCBS
TX00360WMedicare PIN
TX0071KZOtherBCBS