Organization
STRUCTURE CHIROPRACTIC AND PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOMERO CAVAZOS (OWNER)
(214) 914-5684
Entity
Organization
Contact information
Practice address
4508 LEGACY DR, SUITE 200, PLANO, TX 75024-2183
(214) 377-4833
Mailing address
4508 LEGACY DR, SUITE 200, PLANO, TX 75024-2183
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
11011
TX
111NX0800X
Orthopedic Chiropractor
11018
TX
225100000X
Physical Therapist
1152378
TX
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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