Provider Demographics
NPI:1679778898
Name:MATHEWS FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:MATHEWS FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-466-9400
Mailing Address - Street 1:5421 S MATLOCK RD
Mailing Address - Street 2:#125
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001
Mailing Address - Country:US
Mailing Address - Phone:817-466-9400
Mailing Address - Fax:
Practice Address - Street 1:5421 S MATLOCK RD
Practice Address - Street 2:#125
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001
Practice Address - Country:US
Practice Address - Phone:817-466-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty