Provider Demographics
NPI:1548683253
Name:TSJR SERVICE CORP
Entity type:Organization
Organization Name:TSJR SERVICE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:ADRIANNA
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-629-9181
Mailing Address - Street 1:PO BOX 852604
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-2604
Mailing Address - Country:US
Mailing Address - Phone:972-629-9181
Mailing Address - Fax:972-629-9138
Practice Address - Street 1:208 W KEARNEY ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3476
Practice Address - Country:US
Practice Address - Phone:972-629-9181
Practice Address - Fax:972-629-9138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty