Provider Demographics
NPI:1063136893
Name:BA BISHOP PRODUCT AND SERVICES, LLC
Entity type:Organization
Organization Name:BA BISHOP PRODUCT AND SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RRT
Authorized Official - Phone:469-684-1821
Mailing Address - Street 1:8800 US HIGHWAY 380 STE 800
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2516
Mailing Address - Country:US
Mailing Address - Phone:940-440-1211
Mailing Address - Fax:940-440-1212
Practice Address - Street 1:8800 US HIGHWAY 380 STE 800
Practice Address - Street 2:
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-2516
Practice Address - Country:US
Practice Address - Phone:940-440-1211
Practice Address - Fax:940-440-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty