Provider Demographics
NPI:1861705808
Name:SERENITY CHIROPRACTIC & FAMILY WELLNESS CENTER
Entity type:Organization
Organization Name:SERENITY CHIROPRACTIC & FAMILY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:469-231-1510
Mailing Address - Street 1:2340 E TRINITY MILLS RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2340 E TRINITY MILLS RD
Practice Address - Street 2:SUITE 225
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1942
Practice Address - Country:US
Practice Address - Phone:469-231-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11512261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center