Organization
COMPREHENSIVE CHIROPRACTIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH PAUL BRASSIE D.C. (OWNER)
(817) 573-0500
Entity
Organization
Contact information
Practice address
1321 WATERS EDGE DR STE 1003, GRANBURY, TX 76048-1233
(817) 573-0500
(817) 573-0501
Mailing address
1321 WATERS EDGE DR, STE 1003, GRANBURY, TX 76048-1232
(817) 573-0500
(817) 573-0501
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
10149
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067MY
BCBS GROUP
TX
01
—
00846Z
MEDICARE GROUP
TX
01
—
628577
PHCS
TX
01
—
8U4210
BCBS INDIVIDUAL
TX
Enumeration date
03/27/2007
Last updated
05/16/2011
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