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General NPI Number Information
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NPI Number | 1073709150
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Entity Type | Organization
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Legal Business Name | GITTIBAN PA
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 2109 S BOWEN RD
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City | ARLINGTON
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State | TX
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Zip | 76013-5922
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Country | US
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Telephone | 817-261-6100
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Fax | 817-460-7550
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Provider Business Mailing Address
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Address Line | 2109 S BOWEN RD
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City | ARLINGTON
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State | TX
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Zip | 76013-5922
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Country | US
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Telephone | 817-261-6100
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Fax | 817-460-7550
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Authorized Official
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Title or Position | CHIROPRACTOR/PROPRIETOR
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Name | ARSALAN GITTIBAN
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Credential | D.C.
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Telephone | 817-261-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 7849DC
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License Number State | TX
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