380 Chiropractic & Wellness LLC

Organization Active NPI Chiropractor · McKinney, TX

NPI 1194126417 · NPPES record last updated Apr 17, 2015

Key facts

NPI
1194126417
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
10810 (TX)
Legal business name
380 CHIROPRACTIC & WELLNESS LLC
Practice address
2414 W University Dr
112
McKinney, TX 75071-2853
Phone
(214) 901-7211
Fax
(214) 975-2666
NPI assigned
Sep 5, 2014
Organization subpart
No

Authorized official

Name
Dr. Joseph Cacozza III, D.C.
Title
Chiropractor
Phone
(214) 901-7211

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150417001078 TX Part B Supplier - Clinic/Group Practice 4981922101 Receives reassigned benefits from 1 practitioner
Practice locations: McKinney, TX

National Provider Directory

Locations

2414 W University Dr
Ste 112
McKinney, TX 75071
Phone (214) 901-7211

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 10810 TX Yes

Addresses

Primary practice location

2414 W University Dr
112
McKinney, TX 75071-2853

Mailing address

2414 W University Dr
112
McKinney, TX 75071-2853
Phone (214) 901-7211

Other providers in McKinney, TX

All providers in McKinney, TX · Chiropractor in Texas

Sources for this page

Verify at the official NPI Registry.