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General NPI Number Information
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NPI Number | 1376654046
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Entity Type | Organization
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Legal Business Name | PRIME GLOBAL ENTERPRISES, INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3307 BELT LINE RD
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City | GARLAND
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State | TX
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Zip | 75044-6913
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Country | US
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Telephone | 972-496-2225
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Fax | 972-496-3531
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Provider Business Mailing Address
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Address Line | PO BOX 701359
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City | DALLAS
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State | TX
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Zip | 75370-1359
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Country | US
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Telephone | 214-674-2812
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Fax | 972-818-9779
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Authorized Official
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Title or Position | OWNERCHIROPRACTOR
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Name | SHIVA SHIRVANI
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Credential | D.C.
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Telephone | 214-674-2812
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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 | 6778
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6602
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License Number State | TX
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