Provider Demographics
NPI:1386188282
Name:FARNSWORTH CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:FARNSWORTH CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FARNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:254-755-7725
Mailing Address - Street 1:2624 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7449
Mailing Address - Country:US
Mailing Address - Phone:254-755-7725
Mailing Address - Fax:254-755-7726
Practice Address - Street 1:2624 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7449
Practice Address - Country:US
Practice Address - Phone:254-755-7725
Practice Address - Fax:254-755-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2801261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0011330-01 TXMedicaid
601065 TXMedicare PIN