Provider Demographics
NPI:1386068682
Name:OC CHIROPRACTIC
Entity type:Organization
Organization Name:OC CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NGOC-OANH
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN-TONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-496-7645
Mailing Address - Street 1:4750 N. JUPITER RD
Mailing Address - Street 2:STE 219
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044
Mailing Address - Country:US
Mailing Address - Phone:972-496-7645
Mailing Address - Fax:972-496-7685
Practice Address - Street 1:4750 N. JUPITER RD
Practice Address - Street 2:STE 219
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044
Practice Address - Country:US
Practice Address - Phone:972-496-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty