Provider Demographics
NPI:1902621733
Name:SPINEWORKS CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:SPINEWORKS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:TOMAS
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:956-202-3111
Mailing Address - Street 1:1210 W INTERSTATE 2 STE 10
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6504
Mailing Address - Country:US
Mailing Address - Phone:956-510-8254
Mailing Address - Fax:956-510-8253
Practice Address - Street 1:1210 W INTERSTATE 2 STE 10
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6504
Practice Address - Country:US
Practice Address - Phone:956-510-8254
Practice Address - Fax:956-510-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty