NPIMap

Organization Active NPI

Southlake Chiropractic Clinic

  • Chiropractor
  • Southlake, TX
National Provider Identifier
1063743755
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8031 Issued in TX
Legal business name
SOUTHLAKE CHIROPRACTIC CLINIC
Practice address
170 Players Cir Ste 100
Southlake, TX 76092-6947
Phone
(817) 488-8837
Fax
(817) 488-8927
NPI assigned
Jan 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Ann Louise Hebert
Title
Owner/Director
Phone
(817) 488-8837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 8031 TX Primary

Addresses

Primary practice location

170 Players Cir Ste 100
Southlake, TX 76092-6947

Mailing address

170 Players Cir Ste 100
Southlake, TX 76092-6947
Phone (817) 488-8837

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1063743755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PLAYERS CIR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926947",
            "telephone_number": "817-488-8837",
            "fax_number": "817-488-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PLAYERS CIR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926947",
            "telephone_number": "817-488-8837",
            "fax_number": "817-488-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "817-488-8837",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.