Provider Demographics
NPI:1861521890
Name:NORTH TEXAS DISC DECOMPRESSION CENTER, L.L.C.
Entity type:Organization
Organization Name:NORTH TEXAS DISC DECOMPRESSION CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:OLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-892-3471
Mailing Address - Street 1:229 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5833
Mailing Address - Country:US
Mailing Address - Phone:903-892-3471
Mailing Address - Fax:903-893-2745
Practice Address - Street 1:229 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5833
Practice Address - Country:US
Practice Address - Phone:903-892-3471
Practice Address - Fax:903-893-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty