Provider Demographics
NPI:1932311933
Name:BONDS CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:BONDS CHIROPRACTIC, P.C.
Other - Org Name:SPORTS AND SPINE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-248-4994
Mailing Address - Street 1:17330 PRESTON RD
Mailing Address - Street 2:SUITE 140A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5997
Mailing Address - Country:US
Mailing Address - Phone:972-248-4994
Mailing Address - Fax:972-248-4973
Practice Address - Street 1:17330 PRESTON RD
Practice Address - Street 2:140-A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5997
Practice Address - Country:US
Practice Address - Phone:972-248-4994
Practice Address - Fax:972-248-4973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77539Medicare UPIN
TX609282Medicare PIN