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General NPI Number Information
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NPI Number | 1285382580
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Entity Type | Individual
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Provider Name | JOSE LUIS BAEZ RIOS DC
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Gender | Male
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 7700 W NORTHWEST HWY STE 200
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City | DALLAS
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State | TX
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Zip | 75225-2226
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Country | US
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Telephone | 214-393-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 SAN JACINTO DR APT 2123
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City | IRVING
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State | TX
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Zip | 75063-8277
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Country | US
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Telephone | 787-908-2299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15099
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License Number State | TX
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