Healthcare Provider Details

I. General information

NPI: 1508156704
Provider Name (Legal Business Name): ANTHONY PATERNOSTER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2011
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 PRECINCT LINE RD STE 205
HURST TX
76054-3197
US

IV. Provider business mailing address

1717 PRECINCT LINE RD STE 205
HURST TX
76054-3197
US

V. Phone/Fax

Practice location:
  • Phone: 682-200-7447
  • Fax: 682-334-7119
Mailing address:
  • Phone: 682-200-7447
  • Fax: 682-334-7119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11648
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: