NPIMap

Organization Active NPI

Evergreen Chiropractic

  • Chiropractor
  • Colleyville, TX
National Provider Identifier
1871897744
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11586 Issued in TX
Legal business name
EVERGREEN CHIROPRACTIC
Practice address
710 Centerpark Dr
Suite 100
Colleyville, TX 76034-2848
Phone
(682) 325-4193
Fax
(682) 325-4194
NPI assigned
Jan 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Dr. Chung Tao Dylan Lin, D.C.NPI 1164726030
Title
Employee/Chiropractor
Phone
(682) 325-4193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 11586 TX Primary

Addresses

Primary practice location

710 Centerpark Dr
Suite 100
Colleyville, TX 76034-2848

Mailing address

710 Centerpark Dr
Suite 100
Colleyville, TX 76034-2848
Phone (682) 325-4193

National Provider Directory

National Provider Directory

Locations

710 Centerpark Dr
Ste 100
Colleyville, TX 76034
Phone (469) 496-1693

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1871897744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CENTERPARK DR",
            "address_2": "SUITE 100",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760342848",
            "telephone_number": "682-325-4193",
            "fax_number": "682-325-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CENTERPARK DR",
            "address_2": "SUITE 100",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760342848",
            "telephone_number": "682-325-4193",
            "fax_number": "682-325-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "CHUNG TAO",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "EMPLOYEE/CHIROPRACTOR",
        "authorized_official_telephone_number": "682-325-4193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.