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General NPI Number Information
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NPI Number | 1457612137
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Entity Type | Organization
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Legal Business Name | TEAMCHIRO TEXAS LLC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 2900 VILLAGE PKWY 350
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-3300
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Country | US
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Telephone | 469-453-2800
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Fax | 469-453-3131
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Provider Business Mailing Address
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Address Line | 2900 VILLAGE PKWY 350
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-3300
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Country | US
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Telephone | 469-453-2800
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Fax | 469-453-3131
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORDON PAYNE
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Credential | DC
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Telephone | 469-453-2800
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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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