Provider Demographics
NPI:1366566606
Name:METHVIN FAMILY CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:METHVIN FAMILY CHIROPRACTIC, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:METHVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-633-1273
Mailing Address - Street 1:5850 TOWN AND COUNTRY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6942
Mailing Address - Country:US
Mailing Address - Phone:469-633-1273
Mailing Address - Fax:972-712-6026
Practice Address - Street 1:5850 TOWN AND COUNTRY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6942
Practice Address - Country:US
Practice Address - Phone:469-633-1273
Practice Address - Fax:972-712-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081MUOtherBCBS TX GROUP ID