Healthcare Provider Details

I. General information

NPI: 1750610283
Provider Name (Legal Business Name): LAALI MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 LEGACY DR STE 480
PLANO TX
75024-3129
US

IV. Provider business mailing address

5000 LEGACY DR STE 480
PLANO TX
75024-3129
US

V. Phone/Fax

Practice location:
  • Phone: 972-473-6325
  • Fax: 972-767-4344
Mailing address:
  • Phone: 972-473-6325
  • Fax: 972-767-4344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11043
License Number StateTX

VIII. Authorized Official

Name: DR. CYRUS AMMAN LAALI
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 469-766-0808