Healthsource Of South Lake Llc

LBN: Healthsource Of South Lake Llc
Healthsource Of South Lake Llc is an health care organization with primary practice located at 2225 W Southlake Blvd Suite 441, Southlake TX 76092-6750. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Healthsource Of South Lake Llc can be contacted via phone (817) 310-0150, or through Pettke, M Brandon via phone (817) 310-0150.

Contact Information

Primary practice address
2225 W Southlake Blvd Suite 441 Southlake TX 76092-6750
Phone: (817) 310-0150
Fax: (817) 310-0710
Website:
Map and Directions
Authorized official contact:
Name: Pettke, M Brandon Doctor of Chiropractic (DC)
Phone: (817) 310-0150

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X

Profile Details

NPI number 1396025151
LBN Legal business name Healthsource Of South Lake Llc
DBA Doing business as
Authorized official Pettke, M Brandon Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 25th, 2011
Last updated Sep 12th, 2013 - about 11 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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