Provider Demographics
NPI:1255349395
Name:KURBAN, JANETTE A (DC)
Entity type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:A
Last Name:KURBAN
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 1:2207 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5916
Mailing Address - Country:US
Mailing Address - Phone:817-795-1100
Mailing Address - Fax:817-795-1329
Practice Address - Street 1:2207 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5916
Practice Address - Country:US
Practice Address - Phone:817-795-1100
Practice Address - Fax:817-795-1329
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609284OtherBC/BS
TX32904OtherBC/BS
TX32904OtherBC/BS
TX609284Medicare ID - Type Unspecified