1699277400 NPI number — KNIGHT FAMILY CHIROPRACTIC OF ANNA, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699277400 NPI number — KNIGHT FAMILY CHIROPRACTIC OF ANNA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNIGHT FAMILY CHIROPRACTIC OF ANNA, 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:
Provider Other Organization Name Type Code:
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:
1699277400
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1108 W WHITE ST STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75409-5638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-840-4111
Provider Business Mailing Address Fax Number:
469-840-4112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1108 W. WHITE ST.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ANNA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-465-1881
Provider Business Practice Location Address Fax Number:
903-463-4070
Provider Enumeration Date:
03/07/2018

Additional Information

Authorized Official

Authorized Official Last Name:
KNIGHT
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
903-465-1881

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  6450 , 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)





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