Provider Demographics
NPI:1609820406
Name:AVECINA HEALTH CARE INC.
Entity Type:Organization
Organization Name:AVECINA HEALTH CARE INC.
Other - Org Name:BACK & INJURY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ASGHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHARANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC FABS DAAPM
Authorized Official - Phone:214-339-6161
Mailing Address - Street 1:1050 N WESTMORELAND
Mailing Address - Street 2:STE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211
Mailing Address - Country:US
Mailing Address - Phone:314-339-6161
Mailing Address - Fax:214-339-6222
Practice Address - Street 1:1050 N WESTMORELAND RD
Practice Address - Street 2:STE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2444
Practice Address - Country:US
Practice Address - Phone:314-339-6161
Practice Address - Fax:214-339-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC5062111N00000X
TX5062111NI0900X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001574501Medicaid
10007Medicare UPIN
TX603384Medicare ID - Type Unspecified