MEDICARE: KARLA DIANE HADDOCK D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	11121	TX

General Provider Information

NPI Number	:	1578707345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA DIANE HADDOCK D.C.

Provider Business Mailing Address
First Line	:	3311 81ST ST STE B
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-2008
Country	:	US
Telephone Number	:	806-794-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 81ST ST STE B
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-2008
Country	:	US
Telephone Number	:	806-794-4009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	02/03/2025

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