Healthcare Provider Details

I. General information

NPI: 1952598195
Provider Name (Legal Business Name): INJURY ASSISTANCE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 KINWEST PKWY SUITE 100
IRVING TX
75063-3135
US

IV. Provider business mailing address

1121 KINWEST PKWY SUITE 100
IRVING TX
75063-3135
US

V. Phone/Fax

Practice location:
  • Phone: 972-401-1699
  • Fax: 214-522-9428
Mailing address:
  • Phone: 972-401-1699
  • Fax: 214-522-9428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6527
License Number StateTX

VIII. Authorized Official

Name: DR. GREGORY W BUNTING
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 972-401-1699