Healthcare Provider Details

I. General information

NPI: 1912498262
Provider Name (Legal Business Name): JOSEPH POLANI RUANE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 W PARK ROW DR STE 100
PANTEGO TX
76013-2054
US

IV. Provider business mailing address

2920 W PARK ROW DR STE 100
PANTEGO TX
76013-2054
US

V. Phone/Fax

Practice location:
  • Phone: 817-277-1111
  • Fax: 817-861-4593
Mailing address:
  • Phone: 817-277-1111
  • Fax: 817-861-4593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13754
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: