Organization
GEMINI CONCEPTS, INC
Active
Parent organization
GEMINI CONCEPTS, INC
Other names
Back In Action Spinal Decompression Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEMINI CONCEPTS, INC
Authorized official
GREG DAVIDOVICH DC (OWNER/PROVIDER)
(817) 421-9111
Entity
Organization
Contact information
Practice address
680 N CARROLL AVE, SUITE 120, SOUTHLAKE, TX 76092-6475
(817) 421-9111
(817) 421-9222
Mailing address
PO BOX 92248, SOUTHLAKE, TX 76092-0103
(817) 421-9111
(817) 421-9222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6658
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005ND
BCBS
TX
Enumeration date
07/21/2006
Last updated
11/30/2007
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