<Unavail>

LBN: Four-Ten Enterprise, Llc
<Unavail> is an health care organization with primary practice located at 1540 Rice Rd Ste 400 , Tyler TX 75703-3223. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Four-Ten Enterprise, Llc can be contacted via phone (903) 597-9021, or through Sullivan, Jimmy Brian via phone (903) 597-9021.

Contact Information

Primary practice address
1540 Rice Rd Ste 400 Tyler TX 75703-3223
Phone: (903) 597-9021
Fax: (903) 597-0840
Website:
Map and Directions
Authorized official contact:
Name: Sullivan, Jimmy Brian Doctor of Chiropractic (DC)
Phone: (903) 597-9021

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 12808 Texas

Profile Details

NPI number 1619497401
LBN Legal business name Four-Ten Enterprise, Llc
DBA Doing business as <Unavail>
Authorized official Sullivan, Jimmy Brian Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 22nd, 2017
Last updated Jan 17th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619497401 NPPES
Texas Other 583248 MEDICARE

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