Mira Vista Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10692 Issued in TX

Legal business name

MIRA VISTA CHIROPRACTIC

Practice address

6148 Bryant Irvin Rd
Fort Worth, TX 76132-4119

Phone

(817) 292-2200

Fax

(817) 292-2238

NPI assigned

Aug 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Matthew Maitlen, D.C.

Title

Chiropractor / Owner

Phone

(817) 292-2200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1114118965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6148 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324119",
            "telephone_number": "817-292-2200",
            "fax_number": "817-292-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6148 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324119",
            "telephone_number": "817-292-2200",
            "fax_number": "817-292-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA VISTA CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "MAITLEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIROPRACTOR / OWNER",
        "authorized_official_telephone_number": "817-292-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minyard Food Stores Inc.
• Minyard Food Stores Inc.
• Minyard Food Stores Inc.
• Meagan Christine Minzenmayer Proctor
• Tasaduq Hussain Mir, M.D.
• Mira Vista Enterprise, Inc.
• Mira Vista Pharmacy PLLC
• David G Miracle, MA, LPC-ASSOCIATE
• Antonio Miranda, PHD, RD, LD, CDCES
• Erin Miranda, LMSW

• Chiropractor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.