Provider Demographics
NPI:1245541648
Name:PSENCIK, EILEEN F (DC)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:F
Last Name:PSENCIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 GREENVILLE AVENUE STE 904
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-823-1323
Mailing Address - Fax:214-823-1035
Practice Address - Street 1:7515 GREENVILLE AVENUE STE 904
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-823-1323
Practice Address - Fax:214-823-1035
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB120725Medicare PIN