Provider Demographics
NPI:1972812543
Name:TINA BENNETT-BURTON
Entity Type:Organization
Organization Name:TINA BENNETT-BURTON
Other - Org Name:DALLAS CHIROPRACTIC METRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT-BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-718-7832
Mailing Address - Street 1:10 MEDICAL PKWY PLAZA 3 SUITE 201
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7845
Mailing Address - Country:US
Mailing Address - Phone:214-272-9509
Mailing Address - Fax:855-831-8205
Practice Address - Street 1:10 MEDICAL PKWY STE 201
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7845
Practice Address - Country:US
Practice Address - Phone:214-272-9509
Practice Address - Fax:855-831-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX629003OtherMEDICARE
TX3808644-04Medicaid