Provider Demographics
NPI:1760533244
Name:ARK-LA-TEX TOTAL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ARK-LA-TEX TOTAL HEALTHCARE, LLC
Other - Org Name:TOTAL HEALTHCARE OF ARK LA TEX, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:BURLIN
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-334-9110
Mailing Address - Street 1:4412 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WAKE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75501-6352
Mailing Address - Country:US
Mailing Address - Phone:903-334-9110
Mailing Address - Fax:903-223-3753
Practice Address - Street 1:4412 W 7TH ST
Practice Address - Street 2:
Practice Address - City:WAKE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75501-6352
Practice Address - Country:US
Practice Address - Phone:903-334-9110
Practice Address - Fax:903-223-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760474795OtherNPI DR. STACY WARNER, D.C
1760474795OtherNPI DR. STACY WARNER, D.C