DJD Management PC
Organization Active NPI Chiropractor · Lindale, TX
NPI 1124273180 · NPPES record last updated Nov 15, 2012
Key facts
- NPI
- 1124273180
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3092 (TX)
- Legal business name
- DJD MANAGEMENT PC
- Practice address
- 105 E Hubbard St
Lindale, TX 75771-3396 - Phone
- (903) 881-2225
- Fax
- (903) 881-9591
- NPI assigned
- Nov 18, 2008
- Organization subpart
- No
Authorized official
- Name
- Dean A. Darr, D.C.
- Title
- Managing Member
- Phone
- (903) 881-2225
Practitioners 1
-
Dean A. Darr, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090408000653 | TX | Part B Supplier - Clinic/Group Practice | 7719034727 |
Receives reassigned benefits from 1 practitioner Practice locations: Lindale, TX |
National Provider Directory
Locations
649 S Broadway Ave
Ste 1
Tyler, TX 75701
Phone (903) 526-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3092 | TX | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Customized Equipment (DME) | 332BC3200X | 3092 | TX |
Addresses
Primary practice location
105 E Hubbard St
Lindale, TX 75771-3396
Mailing address
105 E Hubbard St
PO Box 385
Lindale, TX 75771-3396
Phone (903) 526-2225
Other names
- Spinal Aid Center of Tyler
Other providers in Lindale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.