Healthcare Provider Details
I. General information
NPI: 1750996336
Provider Name (Legal Business Name): AFFORDABLE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1138 BELT LINE RD STE 135
GARLAND TX
75040-1993
US
IV. Provider business mailing address
1138 BELT LINE RD STE 135
GARLAND TX
75040-1993
US
V. Phone/Fax
- Phone: 469-969-0426
- Fax: 469-969-0425
- Phone: 469-969-0426
- Fax: 469-969-0425
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NI0013X |
| Taxonomy | Independent Medical Examiner Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0200X |
| Taxonomy | Radiology Chiropractor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DENNIS
WAYNE
WILLIAMSON
Title or Position: CEO
Credential: DC
Phone: 469-969-0426