Provider Demographics
NPI:1104281161
Name:ZOAHWAY ENTERPRISES
Entity type:Organization
Organization Name:ZOAHWAY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-587-9614
Mailing Address - Street 1:PO BOX 2971
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-2971
Mailing Address - Country:US
Mailing Address - Phone:781-591-7472
Mailing Address - Fax:
Practice Address - Street 1:150 E HIGHWAY 67 STE 204
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-4481
Practice Address - Country:US
Practice Address - Phone:781-591-7472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13079111NN1001X, 111NR0400X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty