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General NPI Number Information
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NPI Number | 1619156932
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Entity Type | Organization
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Legal Business Name | DR TREV DIXON, D.C., P.A
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 211 S ELM ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-4418
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Country | US
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Telephone | 817-613-1301
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Fax | 817-613-1163
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Provider Business Mailing Address
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Address Line | 211 S ELM ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-4418
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Country | US
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Telephone | 817-613-1301
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Fax | 817-613-1163
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Authorized Official
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Title or Position | OFFICE MGR
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Name | JILL BAILEY
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Credential |
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Telephone | 817-613-1301
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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 | DC5746
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License Number State | TX
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