Basic Information
Provider Information
NPI: 1154451037
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOHR
FirstName: CYNTHIA
MiddleName: CRYSTAL
NamePrefix: DR.
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14901 LAKE FOREST DR
Address2:  
City: DALLAS
State: TX
PostalCode: 752547617
CountryCode: US
TelephoneNumber: 2145925441
FaxNumber:  
Practice Location
Address1: 15110 DALLAS PKWY STE 102
Address2:  
City: DALLAS
State: TX
PostalCode: 752484601
CountryCode: US
TelephoneNumber: 9727920204
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/07/2007
LastUpdateDate: 10/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X9689TXY Chiropractic ProvidersChiropractor 
2255A2300X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer

No ID Information.


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