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Organization

FORD WELLNESS AND REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LESLIE E FORD D.C. (DOCTOR)
(817) 490-9191
Entity
Organization

Contact information

Practice address
100 TROPHY CLUB DR., TROPHY CLUB, TX 76262
(817) 490-9191
(817) 490-9892
Mailing address
100 TROPHY CLUB DR. #108, TROPHY CLUB, TX 76262
(817) 490-9191
(817) 490-9892

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7942
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
606035
BCBS
TX
01
609304
MEDICARE
TX
Enumeration date
08/14/2008
Last updated
02/03/2012
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