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NPI Code Detail

MEDICARE: LABRECQUE FAMILY CHIROPRACTIC, PC

MEDICARE: LABRECQUE FAMILY CHIROPRACTIC, PC
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
1111N00000XChiropractor8106TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100196TOTHERTXMEDICARE GROUP NUMBER

General Provider Information

NPI Number : 1558545368
Entity Type Code : Organization
Provider Name (Legal Business Name) : LABRECQUE FAMILY CHIROPRACTIC, PC
Provider Business Mailing Address
First Line : 7948 DAVIS BLVD # 200
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-1903
Country : US
Telephone Number : 817-577-6061
Fax Number : 817-577-2345
Provider Business Practice Location Address
First Line : 7948 DAVIS BLVD # 200
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-1903
Country : US
Telephone Number : 817-577-6061
Fax Number : 817-577-2345
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. TIFFANY LABRECQUE
Credential : DC
Telephone Number : 817-577-6061
Provider Enumeration Date : 12/28/2007
Last Update Date : 12/28/2007

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Practice Location Address:
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Directions to “LABRECQUE FAMILY CHIROPRACTIC, PC ” Practice Location

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