Healthcare Provider Details

I. General information

NPI: 1093192098
Provider Name (Legal Business Name): CLIFFORD CHIRO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 TRINITY MILLS RD STE 106
DALLAS TX
75287-7604
US

IV. Provider business mailing address

4222 TRINITY MILLS RD STE 106
DALLAS TX
75287-7604
US

V. Phone/Fax

Practice location:
  • Phone: 972-934-1660
  • Fax: 972-934-1633
Mailing address:
  • Phone: 972-934-1660
  • Fax: 972-934-1633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: ROGER CLIFFORD
Title or Position: OWNER
Credential: DC, DACNB
Phone: 972-934-1660