Provider Demographics
NPI:1265553549
Name:PALANCAR CHIROPRACTIC
Entity type:Organization
Organization Name:PALANCAR CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MUSTARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:806-351-2708
Mailing Address - Street 1:3501 SONCY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121
Mailing Address - Country:US
Mailing Address - Phone:805-351-2708
Mailing Address - Fax:806-351-2349
Practice Address - Street 1:3501 SONCY
Practice Address - Street 2:SUITE 2
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121
Practice Address - Country:US
Practice Address - Phone:806-351-2708
Practice Address - Fax:806-351-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty