Eric G. Russell

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9291 Issued in TX

Legal business name

ERIC G. RUSSELL

Practice address

1205 Washington St
Commerce, TX 75428-2613

Phone

(903) 886-3100

Fax

(903) 886-3177

NPI assigned

May 25, 2007

Organization subpart

No

Name

Dr. Eric Glenn Russell, DCNPI 1336183904

Title

Doctor

Phone

(903) 886-3100

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Glenn Russell, DC

  • Chiropractor
  • Commerce, TX
  • NPI 1336183904
  NPD (past) Authorized official

Locations

• Beacon Chiropractic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2009.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243036800000",
    "number": "1033320593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 WASHINGTON ST",
            "city": "COMMERCE",
            "state": "TX",
            "postal_code": "754282613",
            "telephone_number": "903-886-3100",
            "fax_number": "903-886-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 WASHINGTON ST",
            "city": "COMMERCE",
            "state": "TX",
            "postal_code": "754282613",
            "telephone_number": "903-886-3100",
            "fax_number": "903-886-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC G. RUSSELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2009-05-23",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "903-886-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1336183904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033320593",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Commerce, TX
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.