Provider Demographics
NPI:1912263484
Name:DR CARL M. NAEHRITZ III D.C. P.C
Entity Type:Organization
Organization Name:DR CARL M. NAEHRITZ III D.C. P.C
Other - Org Name:TEXAS BACK CARE ACCIDENT AND INJURY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAEHRITZ
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:817-545-1100
Mailing Address - Street 1:2900 HIGHWAY 121 STE 120
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4033
Mailing Address - Country:US
Mailing Address - Phone:817-545-1100
Mailing Address - Fax:817-545-1101
Practice Address - Street 1:2900 HIGHWAY 121 STE 120
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4033
Practice Address - Country:US
Practice Address - Phone:817-545-1100
Practice Address - Fax:817-545-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606312OtherBCRS
603071OtherPTAN
TXP001926..OtherMEDICARE RAILROAD
TX606312OtherBCRS