MEDICARE: EASTSIDE 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
1	111N00000X	Chiropractor	5482	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922163039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTSIDE CHIROPRACTIC, PC

Provider Business Mailing Address
First Line	:	3117 HANDLEY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-7012
Country	:	US
Telephone Number	:	817-457-4441
Fax Number	:	817-457-4467

Provider Business Practice Location Address
First Line	:	3117 HANDLEY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-7012
Country	:	US
Telephone Number	:	817-457-4441
Fax Number	:	817-457-4467

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAZZLE B SHRESTHA
Credential	:
Telephone Number	:	817-457-4441

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	02/24/2011

Similar Medicare Providers

1750944138 — YOLANDA STEWART RN,BSN
Practice Location Address:

1117 BENDING OAK DR APT 423
FORT WORTH, TX
76108-7012

Practice Phone: 817-386-3476
Practice Fax:

1346029279 — DR. JOHN JACK FAKHOURI DC
Practice Location Address:

7012 CHARLESTON SHORES BLVD
LAKE WORTH, FL
33467-7628

Practice Phone: 561-969-8284
Practice Fax:

1205028032 — ELLA CVIRKO DMD
Practice Location Address:

33941 FARRINGTON LN
SPANISH FORT, AL
36527-7012

Practice Phone: 251-272-2666
Practice Fax:

1639613250 — MICHELLE KERN
Practice Location Address:

7012 MORNINGKNOLL DR
FORT WAYNE, IN
46815-7751

Practice Phone: 260-348-1432
Practice Fax:

1659255917 — ANDREW KNIGHT REYES
Practice Location Address:

1539 PHEASANT WALK APT D
FORT PIERCE, FL
34950-7012

Practice Phone: 772-204-1572
Practice Fax:

1750468385 — MARK A RHODES LPC
Practice Location Address:

1160 COUNTRY CLUB LN # 1160
FORT WORTH, TX
76112-2008

Practice Phone: 817-361-7201
Practice Fax: 817-361-7521

Directions to “EASTSIDE CHIROPRACTIC, PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.