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General NPI Number Information
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NPI Number | 1912154766
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Entity Type | Organization
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Legal Business Name | FAMILY CARE & REHAB CENTER, PLLC
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Dates
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Enumeration Date | 08/24/2008
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 2540 E ARKANSAS LN SUITE 100
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City | ARLINGTON
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State | TX
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Zip | 76014-1768
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Country | US
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Telephone | 682-554-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 2540 E ARKANSAS LN SUITE 100
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City | ARLINGTON
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State | TX
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Zip | 76014-1768
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Country | US
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Telephone | 682-554-2686
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHUONG THANH TIEU
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Credential | DC
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Telephone | 682-554-2686
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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 | 9214
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License Number State | TX
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