Healthcare Provider Details

I. General information

NPI: 1144527631
Provider Name (Legal Business Name): HIMMELSEHR CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 FOREST LN S SUITE H
GARLAND TX
75042-7950
US

IV. Provider business mailing address

1530 FOREST LN S SUITE H
GARLAND TX
75042-7950
US

V. Phone/Fax

Practice location:
  • Phone: 972-272-8769
  • Fax: 972-272-8920
Mailing address:
  • Phone: 972-272-8769
  • Fax: 972-272-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number8299
License Number StateTX

VIII. Authorized Official

Name: DR. CRAIG HIMMELSEHR
Title or Position: PRESIDENT
Credential: D.C.
Phone: 972-272-8769