Provider Demographics
NPI:1639353477
Name:CARPENTER FAMILY CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:CARPENTER FAMILY CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:972-462-8282
Mailing Address - Street 1:549 E SANDY LAKE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2015
Mailing Address - Country:US
Mailing Address - Phone:972-462-8282
Mailing Address - Fax:972-462-8603
Practice Address - Street 1:549 E SANDY LAKE RD
Practice Address - Street 2:STE 200
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2015
Practice Address - Country:US
Practice Address - Phone:972-462-8282
Practice Address - Fax:972-462-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X8460OtherBLUE CROSS/BLUE SHIELD