Provider Demographics
NPI:1689811382
Name:ELITE HEALTHCARE GARLAND
Entity Type:Organization
Organization Name:ELITE HEALTHCARE GARLAND
Other - Org Name:TRI-CITY CHIROPRACTIC AND REHABILITATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-556-2150
Mailing Address - Street 1:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-720-9943
Mailing Address - Fax:972-720-0115
Practice Address - Street 1:4002 BROADWAY BLVD.
Practice Address - Street 2:SUITE 101
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:214-556-2150
Practice Address - Fax:214-556-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC9727111N00000X, 111NR0400X, 261QR0401X
TXPT1107050261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy