MEDICARE: 100 CHIRO GIRDY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1184370835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	100 CHIRO GIRDY PLLC

Provider Business Mailing Address
First Line	:	6326 YORKTOWN BLVD STE 7
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5861
Country	:	US
Telephone Number	:	361-737-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6326 YORKTOWN BLVD STE 7
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-5861
Country	:	US
Telephone Number	:	361-737-4222
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	DR. SHANNAN GIRDY
Credential	:	DC
Telephone Number	:	361-737-4222

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	08/01/2022

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