Healthcare Provider Details

I. General information

NPI: 1346362670
Provider Name (Legal Business Name): LARRY DAVID JONES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7236 N MESA ST
EL PASO TX
79912-3653
US

IV. Provider business mailing address

7236 N MESA ST
EL PASO TX
79912-3653
US

V. Phone/Fax

Practice location:
  • Phone: 915-581-7001
  • Fax: 915-581-7603
Mailing address:
  • Phone: 915-581-7001
  • Fax: 915-581-7603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number5045
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: