Provider Demographics
NPI:1669582946
Name:FORLANO, RICO JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:RICO
Middle Name:JOSEPH
Last Name:FORLANO
Suffix:
Gender:M
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:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:TX
Mailing Address - Zip Code:76936-0633
Mailing Address - Country:US
Mailing Address - Phone:325-853-3331
Mailing Address - Fax:325-853-3339
Practice Address - Street 1:418 HWY 277 SOUTH
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:TX
Practice Address - Zip Code:76936-0633
Practice Address - Country:US
Practice Address - Phone:325-853-3331
Practice Address - Fax:325-853-3339
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXDC5447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001577801Medicaid
TX001577801Medicaid
TX603392Medicare ID - Type Unspecified