Healthcare Provider Details

I. General information

NPI: 1467710053
Provider Name (Legal Business Name): POKORNY CHIROPRACTIC CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 W. MORTON
DENISON TX
75020-1623
US

IV. Provider business mailing address

2214 W. MORTON
DENISON TX
75020-1623
US

V. Phone/Fax

Practice location:
  • Phone: 903-465-2225
  • Fax: 903-465-1162
Mailing address:
  • Phone: 903-465-2225
  • Fax: 903-465-1162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4604
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number792625
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP123042
License Number StateTX

VIII. Authorized Official

Name: DR. DAVID M. POKORNY
Title or Position: FNP
Credential: FNP
Phone: 903-465-1162