Healthcare Provider Details

I. General information

NPI: 1619159985
Provider Name (Legal Business Name): AMBER BROOKS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14330 MIDWAY RD STE 116
DALLAS TX
75244-3522
US

IV. Provider business mailing address

14330 MIDWAY RD STE 116
DALLAS TX
75244-3522
US

V. Phone/Fax

Practice location:
  • Phone: 469-547-1173
  • Fax:
Mailing address:
  • Phone: 469-547-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number11239
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: