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General NPI Number Information
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NPI Number | 1114633294
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Entity Type | Organization
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Legal Business Name | NATIVE CHIROPRACTIC & WELLNESS
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 3102 SWISS AVE
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City | DALLAS
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State | TX
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Zip | 75204-6025
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Country | US
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Telephone | 469-291-9129
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Fax | 214-821-9040
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Provider Business Mailing Address
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Address Line | 4215 MUNGER AVE
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City | DALLAS
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State | TX
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Zip | 75204-4417
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Country | US
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Telephone | 915-667-0096
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR / OWNER
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Name | KIMBERLEY NICHOLE AZCARATE - SILVA
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Credential | D.C.
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Telephone | 915-667-0096
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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 |
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License Number State |
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