1649431156 NPI number — SARA DOWNEY, DC

Table of content: (NPI 1649431156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649431156 NPI number — SARA DOWNEY, DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SARA DOWNEY, DC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PAIR OF DOCS
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649431156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 530838
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75053-0838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-642-1919
Provider Business Mailing Address Fax Number:
972-642-1617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
638 W CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND PRAIRIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75050-5529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-642-1919
Provider Business Practice Location Address Fax Number:
972-642-1617
Provider Enumeration Date:
06/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DOWNEY
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
972-642-1919

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  6989 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 607162 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 655606 . This is a "ACN GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00155896 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14208 . This is a "ASH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1055848 . This is a "ASH PROMIS ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 170604601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 608955 . This is a "BCBS GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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