Provider Demographics
NPI:1447542725
Name:ALLIANCE MULTIDISCIPLINARY GROUP LLC
Entity type:Organization
Organization Name:ALLIANCE MULTIDISCIPLINARY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:NOORANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-599-9285
Mailing Address - Street 1:4300 MACARTHUR AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-6524
Mailing Address - Country:US
Mailing Address - Phone:214-599-9285
Mailing Address - Fax:
Practice Address - Street 1:4300 MACARTHUR AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6524
Practice Address - Country:US
Practice Address - Phone:214-599-9285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10023111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty