Healthcare Provider Details

I. General information

NPI: 1184694606
Provider Name (Legal Business Name): WILLIAM HARRY LEDBETTER III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2376 LAVON DR STE. 134
GARLAND TX
75040-9037
US

IV. Provider business mailing address

2376 LAVON DR STE. 134
GARLAND TX
75040-9037
US

V. Phone/Fax

Practice location:
  • Phone: 214-703-9800
  • Fax: 214-703-8001
Mailing address:
  • Phone: 214-703-9800
  • Fax: 214-703-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5758
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: