Healthcare Provider Details

I. General information

NPI: 1578614301
Provider Name (Legal Business Name): SHAWN RUSSELL BARTLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36065 SANTA FE AVE
FORT HOOD TX
76544-5060
US

IV. Provider business mailing address

2531 S SHIELDS ST STE 2J
FORT COLLINS CO
80526-1857
US

V. Phone/Fax

Practice location:
  • Phone: 254-553-9071
  • Fax: 254-288-8327
Mailing address:
  • Phone: 970-472-8333
  • Fax: 970-472-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14058
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: