Provider Demographics
NPI:1811019177
Name:E R CHIROPRACTIC PC
Entity Type:Organization
Organization Name:E R CHIROPRACTIC PC
Other - Org Name:THOUSAND OAKS UNITED CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-490-3555
Mailing Address - Street 1:PO BOX 700867
Mailing Address - Street 2:THOUSAND OAKS UNITED CHIROPRACTIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78270-0867
Mailing Address - Country:US
Mailing Address - Phone:210-490-3555
Mailing Address - Fax:210-490-3577
Practice Address - Street 1:2235 THOUSAND OAKS
Practice Address - Street 2:SUITE 111
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3966
Practice Address - Country:US
Practice Address - Phone:210-490-3555
Practice Address - Fax:210-490-3577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:E.R. CHIROPRACTIC DBA THOUSAND OAKS UNITED CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-05
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4453111N00000X
TXDC4453111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
177994700OtherU S TREASUREY
TX88220YOtherBLUE CROSS BLUE SHIELD
177994700OtherU S TREASUREY
TX00748TMedicare Oscar/Certification
TX8080B7Medicare PIN
TXT13773Medicare UPIN