Healthcare Provider Details

I. General information

NPI: 1184892929
Provider Name (Legal Business Name): CHIROFIX CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 FM 2181 STE 120
HICKORY CREEK TX
75065-7644
US

IV. Provider business mailing address

3630 FM 2181 STE 120
HICKORY CREEK TX
75065-7644
US

V. Phone/Fax

Practice location:
  • Phone: 940-497-7246
  • Fax: 940-497-7246
Mailing address:
  • Phone: 940-497-7246
  • Fax: 940-497-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10112
License Number StateTX

VIII. Authorized Official

Name: DR. MICHAEL SHANE WINFREY
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 940-497-7246