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General NPI Number Information
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NPI Number | 1790940187
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Entity Type | Organization
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Legal Business Name | HEALTH BUILDERS CHIROPRACTIC PA
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 2121 N MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76164-8588
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Country | US
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Telephone | 817-624-7222
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Fax | 817-624-7233
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Provider Business Mailing Address
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Address Line | 2121 N MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76164-8588
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Country | US
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Telephone | 817-624-7222
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Fax | 817-624-7233
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Authorized Official
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Title or Position | OWNER
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Name | MARK W WILLIAMS
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Credential | DC
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Telephone | 817-624-7222
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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 | 6623
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License Number State | TX
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