Provider Demographics
NPI:1760747547
Name:MASRI, MIRNA NABIL (DC)
Entity Type:Individual
Prefix:
First Name:MIRNA
Middle Name:NABIL
Last Name:MASRI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 OMEGA DR
Mailing Address - Street 2:STE 202
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1304 VILLAGE CREEK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4472
Practice Address - Country:US
Practice Address - Phone:972-931-6800
Practice Address - Fax:972-248-0840
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor