Provider Demographics
NPI:1821215211
Name:FRISCO CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:FRISCO CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLINT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LOUGHRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-335-9733
Mailing Address - Street 1:8200 STONEBROOK PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5539
Mailing Address - Country:US
Mailing Address - Phone:972-335-9733
Mailing Address - Fax:972-377-3723
Practice Address - Street 1:8200 STONEBROOK PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5539
Practice Address - Country:US
Practice Address - Phone:972-335-9733
Practice Address - Fax:972-377-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2450OtherBLUE CROSS BLUE SHIELD
TX8B2450OtherBLUE CROSS BLUE SHIELD
TXUT14481-NMedicare UPIN