Provider Demographics
NPI:1982617858
Name:CIZOMBS PLLC
Entity type:Organization
Organization Name:CIZOMBS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-419-6681
Mailing Address - Street 1:130 E BARDIN RD STE 144
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1030
Mailing Address - Country:US
Mailing Address - Phone:817-419-6681
Mailing Address - Fax:817-465-3580
Practice Address - Street 1:130 E BARDIN RD STE 144
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1030
Practice Address - Country:US
Practice Address - Phone:817-419-6681
Practice Address - Fax:817-465-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7906111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00837XMedicare ID - Type UnspecifiedGROUP NUMBER