Healthcare Provider Details
I. General information
NPI: 1073637302
Provider Name (Legal Business Name): MINSHEW-SHURR HEALTHCARE GROUP P A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2007
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14180 DALLAS PKWY SUITE 520
DALLAS TX
75254-4341
US
IV. Provider business mailing address
14180 DALLAS PKWY SUITE 520
DALLAS TX
75254-4341
US
V. Phone/Fax
- Phone: 972-701-9696
- Fax: 972-701-9797
- Phone: 972-701-9696
- Fax: 972-701-9797
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 9402 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
JANIZ
MINSHEW-SHURR
Title or Position: DOCTOR
Credential: D.C.
Phone: 972-701-9696