| Ebcmd Pllc | |
|
411 N Washington Ave Ste 2600 Dallas TX 75246-1713 | |
| (469) 334-0624 | |
| (214) 269-7547 |
| Full Name | Ebcmd Pllc |
|---|---|
| Speciality | Chiropractor |
| Location | 411 N Washington Ave Ste 2600, Dallas, Texas |
| Authorized Official Name and Position | Adam Bohnenblust (PRESIDENT) |
| Authorized Official Contact | 4693340624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebcmd Pllc 411 N Washington Ave Ste 2600 Dallas TX 75246-1713 Ph: (469) 334-0624 | Ebcmd Pllc 411 N Washington Ave Ste 2600 Dallas TX 75246-1713 Ph: (469) 334-0624 |
| NPI Number | 1568914943 |
|---|---|
| Provider Enumeration Date | 11/01/2016 |
| Last Update Date | 11/03/2020 |
| Medicare PECOS PAC ID | 6507278884 |
|---|---|
| Medicare Enrollment ID | O20201210000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568914943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Adam Bohnenblust |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528505096 PECOS PAC ID: 0042622326 Enrollment ID: I20201210000507 |
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