Provider Demographics
NPI:1649688185
Name:DKR HEALTHCARE GROUP, INC.
Entity type:Organization
Organization Name:DKR HEALTHCARE GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREATING DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-942-8100
Mailing Address - Street 1:329 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6505
Mailing Address - Country:US
Mailing Address - Phone:214-942-8100
Mailing Address - Fax:214-942-8107
Practice Address - Street 1:329 CENTRE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6505
Practice Address - Country:US
Practice Address - Phone:214-942-8100
Practice Address - Fax:214-942-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty