Provider Demographics
NPI:1932634672
Name:SUPERIOR HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:SUPERIOR HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MACY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:682-433-2770
Mailing Address - Street 1:1425 W PIONEER DR STE 112
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7124
Mailing Address - Country:US
Mailing Address - Phone:682-433-2770
Mailing Address - Fax:972-253-9357
Practice Address - Street 1:1425 W PIONEER DR STE 112
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7124
Practice Address - Country:US
Practice Address - Phone:682-433-2770
Practice Address - Fax:972-253-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty