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General NPI Number Information
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NPI Number | 1295775096
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Entity Type | Organization
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Legal Business Name | TYLER CHIROPRACTIC, INC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 945 S BAXTER AVE
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City | TYLER
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State | TX
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Zip | 75701-2210
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Country | US
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Telephone | 903-595-2664
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Fax | 903-592-8461
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Provider Business Mailing Address
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Address Line | 945 S BAXTER AVE
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City | TYLER
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State | TX
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Zip | 75701-2210
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Country | US
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Telephone | 903-595-2664
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Fax | 903-592-8461
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES ALLEN SMITH
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Credential | D.C.
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Telephone | 903-595-2664
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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 | DC9333
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC2507
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License Number State | TX
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