Provider Demographics
NPI:1366565830
Name:UM, RI RA (DC)
Entity type:Individual
Prefix:
First Name:RI RA
Middle Name:
Last Name:UM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4224
Mailing Address - Country:US
Mailing Address - Phone:214-316-3073
Mailing Address - Fax:972-517-1311
Practice Address - Street 1:2050 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4224
Practice Address - Country:US
Practice Address - Phone:214-316-3073
Practice Address - Fax:972-517-1311
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor