Organization
CARROLLTON ENTERPRISES CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM VAN PHAM D.C. (OWNER)
(972) 417-0651
Entity
Organization
Contact information
Practice address
1005 S JOSEY LN, SUITE 203, CARROLLTON, TX 75006-7663
(972) 417-0651
(972) 294-3789
Mailing address
4287 BELT LINE RD, 303, ADDISON, TX 75001-4510
(972) 417-0651
(972) 417-1851
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092KB
BCBS GROUP NUMBER
TX
01
—
8J3410
BCBS INDIVIDUAL PROVIDER
TX
Enumeration date
04/04/2007
Last updated
03/22/2010
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