Provider Demographics
NPI:1366767865
Name:EXPRESSIONS CHIROPRACTIC & REHAB OF NRH
Entity type:Organization
Organization Name:EXPRESSIONS CHIROPRACTIC & REHAB OF NRH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRTLAND
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SPEAKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-898-0691
Mailing Address - Street 1:7500 BOULIVARD 26
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180
Mailing Address - Country:US
Mailing Address - Phone:817-259-1300
Mailing Address - Fax:817-259-1301
Practice Address - Street 1:7500 BOULIVARD 26
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180
Practice Address - Country:US
Practice Address - Phone:817-259-1300
Practice Address - Fax:817-259-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU53866Medicare UPIN
TX612325Medicare PIN