Healthcare Provider Details

I. General information

NPI: 1891096251
Provider Name (Legal Business Name): GRENNAN CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date: 09/24/2014
Reactivation Date: 05/21/2015

III. Provider practice location address

7447 N MACARTHUR BLVD SUITE 180
IRVING TX
75063-7509
US

IV. Provider business mailing address

7447 N MACARTHUR BLVD SUITE 180
IRVING TX
75063-7509
US

V. Phone/Fax

Practice location:
  • Phone: 972-253-1500
  • Fax: 972-253-1505
Mailing address:
  • Phone: 972-253-1500
  • Fax: 972-253-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6435
License Number StateTX

VIII. Authorized Official

Name: DR. CAROL E GRENNAN
Title or Position: OWNER
Credential: D.C
Phone: 972-253-1500