Active NPI
Mark Mathis Jr., DC
- Chiropractor
- Irving, TX
National Provider Identifier
1063980670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13943
- Practice address
- 611 N Macarthur Blvd Ste 110
Irving, TX 75061-7467 - Phone
- (972) 253-9355
- Fax
- (972) 253-9357
- NPI assigned
- Nov 13, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13943 | TX | Primary |
Addresses
Primary practice location
611 N Macarthur Blvd Ste 110
Irving, TX 75061-7467
Mailing address
611 N Macarthur Blvd Ste 110
Irving, TX 75061-7467
Phone (972) 253-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13943 | Other | TX | CHIROPRACTIC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13943 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1063980670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N MACARTHUR BLVD STE 110",
"city": "IRVING",
"state": "TX",
"postal_code": "750617467",
"telephone_number": "972-253-9355",
"fax_number": "972-253-9357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 N MACARTHUR BLVD STE 110",
"city": "IRVING",
"state": "TX",
"postal_code": "750617467",
"telephone_number": "972-253-9355",
"fax_number": "972-253-9357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "MARK",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-13",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTIC LICENSE",
"identifier": "13943",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.