Healthcare Provider Details

I. General information

NPI: 1528069333
Provider Name (Legal Business Name): MICHAEL PAUL MCGARRAH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 HIGHWAY 121 SUITE A
BEDFORD TX
76021-4037
US

IV. Provider business mailing address

3004 HIGHWAY 121 SUITE A
BEDFORD TX
76021-4037
US

V. Phone/Fax

Practice location:
  • Phone: 817-283-5333
  • Fax: 817-571-9756
Mailing address:
  • Phone: 817-283-5333
  • Fax: 817-571-9756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4131
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: