Provider Demographics
NPI:1396057444
Name:K. M. RACHOW ENTERPRISES LLC
Entity type:Organization
Organization Name:K. M. RACHOW ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:RACHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-539-3105
Mailing Address - Street 1:2200 MORRISS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3598
Mailing Address - Country:US
Mailing Address - Phone:972-874-5900
Mailing Address - Fax:972-874-5905
Practice Address - Street 1:2200 MORRISS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3598
Practice Address - Country:US
Practice Address - Phone:972-874-5900
Practice Address - Fax:972-874-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty