Provider Demographics
NPI:1902933690
Name:DEAN A. DARR, D.C., P.A.
Entity Type:Organization
Organization Name:DEAN A. DARR, D.C., P.A.
Other - Org Name:SPINAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-526-2225
Mailing Address - Street 1:649 S BROADWAY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1677
Mailing Address - Country:US
Mailing Address - Phone:903-526-2225
Mailing Address - Fax:903-526-2413
Practice Address - Street 1:460 ASHLEY RIDGE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7228
Practice Address - Country:US
Practice Address - Phone:903-526-2225
Practice Address - Fax:903-526-2413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5793930001Medicare NSC
LA5CY92Medicare UPIN
LA3A370Medicare PIN