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General NPI Number Information
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NPI Number | 1235658279
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Entity Type | Organization
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Legal Business Name | SIA CHIROPRACTIC ASSOCIATES LLC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2409 ALCO AVE
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City | DALLAS
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State | TX
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Zip | 75211-2614
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Country | US
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Telephone | 214-613-1995
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Fax | 214-613-1078
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Provider Business Mailing Address
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Address Line | 2409 ALCO AVE
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City | DALLAS
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State | TX
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Zip | 75211-2614
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Country | US
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Telephone | 214-613-1995
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Fax | 214-613-1078
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | IMRAN SHARIF
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Credential |
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Telephone | 281-796-3342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 10096
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License Number State | TX
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