Provider Demographics
NPI:1205258142
Name:ROSS FAMILY CLINICS, PLLC
Entity type:Organization
Organization Name:ROSS FAMILY CLINICS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-633-4605
Mailing Address - Street 1:600 DIVISION AVE STE G
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-1336
Mailing Address - Country:US
Mailing Address - Phone:210-332-9005
Mailing Address - Fax:210-332-9004
Practice Address - Street 1:600 DIVISION AVE STE G
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-1336
Practice Address - Country:US
Practice Address - Phone:210-332-9005
Practice Address - Fax:210-332-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12090111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty