Healthcare Provider Details

I. General information

NPI: 1912636002
Provider Name (Legal Business Name): TYLER CHAD MCWHORTER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7304 N COMANCHE AVE
WARR ACRES OK
73132-6635
US

IV. Provider business mailing address

7304 N COMANCHE AVE
WARR ACRES OK
73132-6635
US

V. Phone/Fax

Practice location:
  • Phone: 405-728-4851
  • Fax:
Mailing address:
  • Phone: 405-728-4851
  • Fax: 405-728-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4487
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: