Provider Demographics
NPI:1972994127
Name:DALLAS CHIROPRACTIC & KINESIOLOGY, PLLC
Entity type:Organization
Organization Name:DALLAS CHIROPRACTIC & KINESIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:LOCK
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:512-663-3052
Mailing Address - Street 1:7136 CORNELIA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3225
Mailing Address - Country:US
Mailing Address - Phone:512-663-3052
Mailing Address - Fax:
Practice Address - Street 1:7515 GREENVILLE AVE STE 904
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3834
Practice Address - Country:US
Practice Address - Phone:214-823-3390
Practice Address - Fax:214-823-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11669111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty