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General NPI Number Information
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NPI Number | 1508132218
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Entity Type | Organization
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Legal Business Name | VITA CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 5646 MILTON ST SUITE 608A
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City | DALLAS
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State | TX
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Zip | 75206-3907
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Country | US
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Telephone | 469-554-8482
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Fax |
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Provider Business Mailing Address
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Address Line | 5646 MILTON ST SUITE 608A
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City | DALLAS
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State | TX
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Zip | 75206-3907
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Country | US
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Telephone | 469-554-8482
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GEORGE GARCIA
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Credential | DC
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Telephone | 469-554-8482
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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 | 12039
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 12039
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 12040
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12040
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License Number State | TX
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