Provider Demographics
NPI:1730368457
Name:LOREN MATHES CHIROPRACTIC CARE CENTERS INC.
Entity type:Organization
Organization Name:LOREN MATHES CHIROPRACTIC CARE CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:MATHES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-691-3200
Mailing Address - Street 1:1501 MIDWESTERN PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-1577
Mailing Address - Country:US
Mailing Address - Phone:940-691-3200
Mailing Address - Fax:940-691-7715
Practice Address - Street 1:1501 MIDWESTERN PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-1577
Practice Address - Country:US
Practice Address - Phone:940-691-3200
Practice Address - Fax:940-691-7715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP087W5416PAMedicaid
TX00N75XMedicare PIN
TX87W541Medicare PIN
TXU51749Medicare UPIN