Provider Demographics
NPI:1588876502
Name:ESPANAS CHIROPRACTIC TREATMENT CENTER
Entity type:Organization
Organization Name:ESPANAS CHIROPRACTIC TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC DABCO
Authorized Official - Phone:214-942-4015
Mailing Address - Street 1:PO BOX 5226
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-9226
Mailing Address - Country:US
Mailing Address - Phone:214-942-4015
Mailing Address - Fax:214-942-4980
Practice Address - Street 1:1107 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5145
Practice Address - Country:US
Practice Address - Phone:214-942-4015
Practice Address - Fax:214-942-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0047PSOtherBCBS
TX00Z562OtherMEDICARE PTAN