Provider Demographics
NPI:1689078578
Name:DFW INJURY CLINIC
Entity Type:Organization
Organization Name:DFW INJURY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-279-9111
Mailing Address - Street 1:3501 GUS THOMASSON RD
Mailing Address - Street 2:SUITE # 75
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3699
Mailing Address - Country:US
Mailing Address - Phone:972-279-9111
Mailing Address - Fax:972-279-9115
Practice Address - Street 1:3501 GUS THOMASSON RD
Practice Address - Street 2:SUITE # 75
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3699
Practice Address - Country:US
Practice Address - Phone:972-279-9111
Practice Address - Fax:972-279-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty