Healthcare Provider Details

I. General information

NPI: 1699783878
Provider Name (Legal Business Name): MICHAEL PATRICK WOJNICKI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 W STACY RD STE 180
ALLEN TX
75013-5044
US

IV. Provider business mailing address

939 W STACY RD STE 180
ALLEN TX
75013-5044
US

V. Phone/Fax

Practice location:
  • Phone: 214-547-9600
  • Fax: 214-383-2375
Mailing address:
  • Phone: 214-547-9600
  • Fax: 214-383-2375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9095
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: