Provider Demographics
NPI:1912183088
Name:ERIN M. STARK, DC, FICPA, PA
Entity Type:Organization
Organization Name:ERIN M. STARK, DC, FICPA, PA
Other - Org Name:APEX WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FICPA, PA
Authorized Official - Phone:972-392-9402
Mailing Address - Street 1:6029 BELT LINE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9109
Mailing Address - Country:US
Mailing Address - Phone:972-392-9402
Mailing Address - Fax:972-392-1903
Practice Address - Street 1:6029 BELT LINE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-9109
Practice Address - Country:US
Practice Address - Phone:972-392-9402
Practice Address - Fax:972-392-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R6900OtherBCBS