Provider Demographics
NPI:1144641127
Name:PINEWOOD CHIROPRACTIC 1 PLLC
Entity type:Organization
Organization Name:PINEWOOD CHIROPRACTIC 1 PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:214-220-1212
Mailing Address - Street 1:6060 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 318
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5209
Mailing Address - Country:US
Mailing Address - Phone:214-220-1212
Mailing Address - Fax:214-220-3773
Practice Address - Street 1:6060 N CENTRAL EXPY
Practice Address - Street 2:SUITE 318
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5209
Practice Address - Country:US
Practice Address - Phone:214-220-1212
Practice Address - Fax:214-220-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty