Provider Demographics
NPI:1669740668
Name:RAK SHIV LAD PC
Entity type:Organization
Organization Name:RAK SHIV LAD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-377-0600
Mailing Address - Street 1:11550 LEGACY DR
Mailing Address - Street 2:STE 480
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1997
Mailing Address - Country:US
Mailing Address - Phone:972-377-0600
Mailing Address - Fax:972-377-0750
Practice Address - Street 1:11550 LEGACY DR
Practice Address - Street 2:STE 480
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1997
Practice Address - Country:US
Practice Address - Phone:972-377-0600
Practice Address - Fax:972-377-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty