Provider Demographics
NPI:1821210873
Name:NEW START CHIROPRACTIC
Entity Type:Organization
Organization Name:NEW START CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYOUNG
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-406-8844
Mailing Address - Street 1:2720 ROYAL LANE
Mailing Address - Street 2:SUITE #190
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229
Mailing Address - Country:US
Mailing Address - Phone:972-406-8844
Mailing Address - Fax:972-484-4829
Practice Address - Street 1:2720 ROYAL LANE
Practice Address - Street 2:SUITE #190
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229
Practice Address - Country:US
Practice Address - Phone:972-406-8844
Practice Address - Fax:972-484-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7992111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609097Medicare ID - Type Unspecified