MEDICARE: DR. WINFORD OLAS WOOLVERTON DC

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	111N00000X	Chiropractor	DC2075	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83Y026	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1457456352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WINFORD OLAS WOOLVERTON DC

Provider Business Mailing Address
First Line	:	2093 N COLLINS BLVD
Second Line	:	STE 105
City	:	RICHARDSON
State	:	TX
Zip	:	75080-8301
Country	:	US
Telephone Number	:	972-231-4231
Fax Number	:	972-907-8900

Provider Business Practice Location Address
First Line	:	2093 N COLLINS BLVD
Second Line	:	STE 105
City	:	RICHARDSON
State	:	TX
Zip	:	75080-8301
Country	:	US
Telephone Number	:	972-231-4231
Fax Number	:	972-907-8900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	05/10/2026

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Directions to “ DR. WINFORD OLAS WOOLVERTON DC” Practice Location

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