Provider Demographics
NPI:1154543395
Name:HORIZON CHIROPRACTIC AND WELLNESS CENTER PC
Entity type:Organization
Organization Name:HORIZON CHIROPRACTIC AND WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:PENDERGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-478-8700
Mailing Address - Street 1:5609 SW GREEN OAKS BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017
Mailing Address - Country:US
Mailing Address - Phone:817-478-8700
Mailing Address - Fax:817-478-8405
Practice Address - Street 1:5609 SW GREEN OAKS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1153
Practice Address - Country:US
Practice Address - Phone:817-478-8700
Practice Address - Fax:817-478-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty