Provider Demographics
NPI:1306606330
Name:LIBERTY HEALTHCARE UNITED, PA
Entity type:Organization
Organization Name:LIBERTY HEALTHCARE UNITED, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:H.R.
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-396-6493
Mailing Address - Street 1:PO BOX 47 2502
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75047
Mailing Address - Country:US
Mailing Address - Phone:214-275-7200
Mailing Address - Fax:972-278-8718
Practice Address - Street 1:112 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050
Practice Address - Country:US
Practice Address - Phone:214-275-7200
Practice Address - Fax:972-278-8718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty