Provider Demographics
NPI:1902085012
Name:HEALTH CHOICE CHIROPRACTIC
Entity Type:Organization
Organization Name:HEALTH CHOICE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-922-9890
Mailing Address - Street 1:3131 TURTLE CREEK BLVD
Mailing Address - Street 2:SUITE 820
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5405
Mailing Address - Country:US
Mailing Address - Phone:214-922-9890
Mailing Address - Fax:214-303-1633
Practice Address - Street 1:3131 TURTLE CREEK BLVD
Practice Address - Street 2:SUITE 820
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5405
Practice Address - Country:US
Practice Address - Phone:214-922-9890
Practice Address - Fax:214-303-1633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0077LCOtherBLUE CROSS BLUE SHIELD
TX0048XMedicare PIN
TX0077LCOtherBLUE CROSS BLUE SHIELD