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General NPI Number Information
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NPI Number | 1649457896
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Entity Type | Organization
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Legal Business Name | CHANNING ENTERPRISE INC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 1009 BAKER ST
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City | FORT WORTH
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State | TX
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Zip | 76104-7211
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Country | US
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Telephone | 817-926-8333
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Fax |
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Provider Business Mailing Address
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Address Line | 7309 FREDRICKSBURG DR
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City | FOREST HILL
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State | TX
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Zip | 76140-2517
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASST.CEO
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Name | MR. BILLY EARL
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Credential |
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Telephone | 817-366-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | TX
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