Provider Demographics
NPI:1013929835
Name:CHIRO INCORPORATED
Entity Type:Organization
Organization Name:CHIRO INCORPORATED
Other - Org Name:CHIRO HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-727-7600
Mailing Address - Street 1:2100 CORPUS CHRISTI ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-3361
Mailing Address - Country:US
Mailing Address - Phone:956-727-7600
Mailing Address - Fax:956-727-9188
Practice Address - Street 1:2100 CORPUS CHRISTI ST
Practice Address - Street 2:SUITE 14
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-3361
Practice Address - Country:US
Practice Address - Phone:956-727-7600
Practice Address - Fax:956-727-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF006725302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W367Medicare ID - Type Unspecified