Provider Demographics
NPI:1861510935
Name:CHIRO & ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:CHIRO & ACUPUNCTURE, INC.
Other - Org Name:CHIRO & ACUPUNCTURE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:TAEHO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-552-7246
Mailing Address - Street 1:1000 TEXAN TRL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3776
Mailing Address - Country:US
Mailing Address - Phone:817-329-6949
Mailing Address - Fax:817-310-3058
Practice Address - Street 1:1000 TEXAN TRL
Practice Address - Street 2:SUITE 120
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3776
Practice Address - Country:US
Practice Address - Phone:817-329-6949
Practice Address - Fax:817-310-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082PCOtherBLUE CROSS BLUE SHIELD