Provider Demographics
NPI:1588494074
Name:CARIDE, ANGELINA RENE (DC)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:RENE
Last Name:CARIDE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 FORD RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7256
Mailing Address - Country:US
Mailing Address - Phone:469-257-1020
Mailing Address - Fax:
Practice Address - Street 1:12000 FORD RD STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7256
Practice Address - Country:US
Practice Address - Phone:469-257-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor