Provider Demographics
NPI:1801043831
Name:H. E. B. CHIROPRACTIC & REHAB CENTER, P.A.
Entity Type:Organization
Organization Name:H. E. B. CHIROPRACTIC & REHAB CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-354-7300
Mailing Address - Street 1:451 WESTPARK WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3703
Mailing Address - Country:US
Mailing Address - Phone:817-354-7300
Mailing Address - Fax:817-799-0866
Practice Address - Street 1:451 WESTPARK WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3703
Practice Address - Country:US
Practice Address - Phone:817-354-7300
Practice Address - Fax:817-799-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty