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General NPI Number Information
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NPI Number | 1013162676
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Entity Type | Organization
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Legal Business Name | BACKMENDERS
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 6464 E NORTHWEST HWY SUITE 331, MEDALLION CENTER
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City | DALLAS
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State | TX
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Zip | 75214-7800
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Country | US
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Telephone | 469-232-6363
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Fax | 469-232-2225
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Provider Business Mailing Address
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Address Line | 6464 E NORTHWEST HWY SUITE 331, MEDALLION CENTER
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City | DALLAS
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State | TX
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Zip | 75214-7800
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Country | US
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Telephone | 469-232-6363
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Fax | 469-232-2225
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Authorized Official
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Title or Position | OWNER - CHIROPRACTOR
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Name | DR. GEORGE CHARLES KOBDISH JR.
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Credential | D.C.
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Telephone | 469-232-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10531
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License Number State | TX
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