1346477213 NPI number — LKL ENTERPRISES, LLC

Table of content: (NPI 1346477213)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346477213 NPI number — LKL ENTERPRISES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LKL ENTERPRISES, LLC
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:
BEST LIFE CHIROPRACTIC AND WELLNESS CENTER
Provider Other Organization Name Type Code:
3
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:
1346477213
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 LONG PRAIRIE RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FLOWER MOUND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75028-1794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-539-7500
Provider Business Mailing Address Fax Number:
972-539-7550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 LONG PRAIRIE RD
Provider Second Line Business Practice Location Address:
STE. 200
Provider Business Practice Location Address City Name:
FLOWER MOUND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75028-1794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-539-7500
Provider Business Practice Location Address Fax Number:
972-539-7550
Provider Enumeration Date:
06/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KUKUCSKA LE
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
972-539-7500

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  9520 , 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: 1346477213 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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