Provider Demographics
NPI:1770728651
Name:BACK CARE ASSOCIATES, INC.
Entity type:Organization
Organization Name:BACK CARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINGCAID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-486-7044
Mailing Address - Street 1:PO BOX 58713
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8713
Mailing Address - Country:US
Mailing Address - Phone:281-486-7044
Mailing Address - Fax:
Practice Address - Street 1:17313 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2718
Practice Address - Country:US
Practice Address - Phone:281-486-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7018261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU62353Medicare UPIN
TX00079TMedicare PIN