Provider Demographics
NPI:1851692412
Name:JEB0321 PA
Entity Type:Organization
Organization Name:JEB0321 PA
Other - Org Name:CORE CHIROPRACTIC AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ELBERT
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-899-2258
Mailing Address - Street 1:2851 CROSS TIMBERS RD STE 111
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2791
Mailing Address - Country:US
Mailing Address - Phone:214-215-8898
Mailing Address - Fax:972-899-2425
Practice Address - Street 1:2851 CROSS TIMBERS RD STE 111
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2791
Practice Address - Country:US
Practice Address - Phone:214-215-8898
Practice Address - Fax:972-899-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty