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General NPI Number Information
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NPI Number | 1578760617
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Entity Type | Organization
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Legal Business Name | INJURY CARE ASSOCIATES PA
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 6161 HARRY HINES BLVD SUITE 218
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City | DALLAS
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State | TX
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Zip | 75235-5387
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Country | US
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Telephone | 972-701-8181
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Fax | 972-701-8182
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Provider Business Mailing Address
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Address Line | PO BOX 542581
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City | DALLAS
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State | TX
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Zip | 75354-2581
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Country | US
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Telephone | 972-701-8181
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Fax | 972-701-8182
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Authorized Official
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Title or Position | ASSOCIATE
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Name | ELHAM KAIVAN-MEHR
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Credential | DC
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Telephone | 972-701-8181
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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 | 9455
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | J3024
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9504
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License Number State | TX
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