Main Street Injury Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MAIN STREET INJURY CLINIC LLC

Practice address

2100 N Main St Ste 105
Fort Worth, TX 76164-8572

Phone

(817) 402-9484

Fax

(214) 853-5421

NPI assigned

Aug 31, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edwardo Dehoyos, MHA

Title

Partner

Phone

(817) 402-9484

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1154099596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 105",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648572",
            "telephone_number": "817-402-9484",
            "fax_number": "214-853-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 105",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761648572",
            "telephone_number": "817-402-9484",
            "fax_number": "214-853-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET INJURY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "DEHOYOS",
        "authorized_official_first_name": "EDWARDO",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "817-402-9484",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Van Mai, PHARMD.
• Vuong Ba Mai, D.O.
• Brenda Maier, COA
• Michael Joseph Maiers, M.D.
• Jedida Maigua
• Heather Main, LMSW
• Dinesh Mainali, MD
• Melanie Christine Maine, LPC-S
• Pamela J Mainous
• Kenneth Aaron Mair, M.D.

• Chiropractor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.