Provider Demographics
NPI:1699181537
Name:INNOVATIVE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:INNOVATIVE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-943-0336
Mailing Address - Street 1:1045 15TH PL
Mailing Address - Street 2:SUITE 157
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6247
Mailing Address - Country:US
Mailing Address - Phone:972-943-0336
Mailing Address - Fax:972-943-0997
Practice Address - Street 1:1045 15TH PL
Practice Address - Street 2:SUITE 157
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6247
Practice Address - Country:US
Practice Address - Phone:972-943-0336
Practice Address - Fax:972-943-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1184037194OtherNPI 1