Provider Demographics
NPI:1013162676
Name:BACKMENDERS
Entity Type:Organization
Organization Name:BACKMENDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:KOBDISH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:469-232-6363
Mailing Address - Street 1:6464 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 331, MEDALLION CENTER
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-7800
Mailing Address - Country:US
Mailing Address - Phone:469-232-6363
Mailing Address - Fax:469-232-2225
Practice Address - Street 1:6464 E NORTHWEST HWY
Practice Address - Street 2:SUITE 331, MEDALLION CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-7800
Practice Address - Country:US
Practice Address - Phone:469-232-6363
Practice Address - Fax:469-232-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty