Provider Demographics
NPI:1538376322
Name:L & L CENTRAL HEALTHCARE, P.C.
Entity type:Organization
Organization Name:L & L CENTRAL HEALTHCARE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-649-9800
Mailing Address - Street 1:2800 FORESTWOOD DR
Mailing Address - Street 2:STE 102
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2792
Mailing Address - Country:US
Mailing Address - Phone:817-649-9800
Mailing Address - Fax:817-649-9803
Practice Address - Street 1:2800 FORESTWOOD DR
Practice Address - Street 2:STE 102
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2792
Practice Address - Country:US
Practice Address - Phone:817-649-9800
Practice Address - Fax:817-649-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80560XOtherBCBS
TX1265542781OtherNPI
TX1538376322OtherGROUP NPI
TX00676KMedicare PIN
TX1265542781OtherNPI