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NPI Code Detail

MEDICARE: CHIRODOCTOR P A

MEDICARE: CHIRODOCTOR P A
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
1111N00000XChiropractor9263TX

General Provider Information

NPI Number : 1285798371
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHIRODOCTOR P A
Provider Business Mailing Address
First Line : 16135 PRESTON RD
Second Line : STE. 127, BOX 37
City : DALLAS
State : TX
Zip : 75248-3599
Country : US
Telephone Number : 972-867-7463
Fax Number :
Provider Business Practice Location Address
First Line : 16135 PRESTON RD
Second Line : STE. 127
City : DALLAS
State : TX
Zip : 75248-3599
Country : US
Telephone Number : 972-867-7463
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. SHELBY G DOUGLAS
Credential : DC
Telephone Number : 972-867-7463
Provider Enumeration Date : 12/21/2006
Last Update Date : 12/19/2007

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Practice Location Address:
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Directions to “CHIRODOCTOR P A ” Practice Location

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