PROFORM CLINICS LLC (NPI# 1528607330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528607330 |
| Entity Type | Organization |
| Organization Name | PROFORM CLINICS LLC |
| Practice Address |
1017 Long Praire Road, Suite 202 Flower Mound TX 75022-4224 |
| Practice Telephone | 4694532800 |
| Practice Fax Number | 4694533131 |
| Mailing Telephone | 4694532800 |
| Mailing Fax Number | 4694533131 |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |
| Authorized Official Name | DR. GORDON R PAYNE (OWNER) |
| Authorized Official Telephone | 4694532800 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
1017 LONG PRAIRE ROAD, SUITE 202 |
| City | FLOWER MOUND |
| State | TX |
| Zip Code | 75022-4224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396356622 | Ann Ball | Nurse Practitioner | 2405 Bayshore Drive, Flower Mound, TX 75022 | 2020-08-11 |
| 1679183172 | Stacie Teresa Mccally | Nurse Practitioner | 4055 Valley View Lane, Dallas, TX 75022 | 2020-08-09 |
| 1194344812 | Today Dental of Flower Mound Pllc | Dentist | 2840 Flower Mound Rd, Suite 120, Flower Mound, TX 75022 | 2020-04-13 |
| 1801398375 | Lumincare Physician Group, Pa | Family Medicine | 2628 Long Prairie Road Suite 107, Flower Mound, TX 75022 | 2018-03-01 |
| 1861948572 | Icarepros, LLC | Home Health | 4508 Cassandra Drive, Flower Mound, TX 75022 | 2016-09-01 |
| 1912378837 | Tmj & Sleep Therapy Centre of North Texas, LLC | Dentist | 1005 Long Prairie Road, Suite 100, Flower Mound, TX 75022 | 2015-10-19 |
| 1689056863 | Twila Michelle Farrar | Counselor | 1033 Long Prairie Road, Suite 4, Flower Mound, TX 75022 | 2015-06-24 |
| 1992186597 | Kelly Fuller Lewis | Pediatrics | 3041 Churchill Dr Ste 300, Flower Mound, TX 75022 | 2015-06-09 |
| 1679989313 | Uap Keller Endo, LLC | Nurse Anesthetist, Certified Registered | 1001 Surrey Lane, Flower Mound, TX 75022 | 2014-07-02 |
| 1013269273 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 4301 Cross Timbers Rd., Flowermound, TX 75022 | 2012-10-11 |
| Find all providers in zip 75022 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205328143 | Anthony Fortier | Chiropractor | 3208 Long Prairie Rd Ste C, Flower Mound, TX 75022-4960 | 2018-06-06 |
| 1396237814 | Jessica Carol Mohrbeck | Chiropractor | 3305 Long Prairie Rd Ste 120, Flower Mound, TX 75022-2775 | 2018-05-31 |
| 1164921425 | Stephanie Marie Chase | Chiropractor | 1011 Surrey Ln Bldg 200, Flower Mound, TX 75022-4234 | 2018-02-01 |
| 1326557786 | Alasha Young | Chiropractor | 4401 Long Prairie Rd Ste 200, Flower Mound, TX 75028-2007 | 2017-09-28 |
| 1932658127 | Abundant Living Health and Wellness Pllc | Chiropractor | 2913 Corporate Cir Ste 400, Flower Mound, TX 75028-5616 | 2016-09-28 |
| 1912379447 | Nix Family Chiropractic | Chiropractor | 2401 Creekhaven Dr, Flower Mound, TX 75028-7565 | 2015-10-23 |
| 1710369491 | Medical Massage Rx | Chiropractor | 2616 Long Prairie Rd., Suite 101, Flower Mound, TX 75028 | 2015-06-18 |
| 1326439274 | Yong Shin | Chiropractor | 821 Canongate Dr, Flower Mound, TX 75022-8012 | 2015-02-13 |
| 1982001178 | Freedom Wellness Center | Chiropractor | 2200 Morriss Rd Ste 200, Flower Mound, TX 75028-3245 | 2014-12-03 |
| 1366867731 | Fmwc, LLC. | Chiropractor | 4051 Kirkpatrick Ln, Ste 300, Flower Mound, TX 75028-1802 | 2014-02-21 |
| Find all providers in FLOWER MOUND | ||||
| City | FLOWER MOUND |
| Zip Code | 75022 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.