NPIMap

Organization Active NPI

Stice Chiropractic & Wellness Center

  • Chiropractor
  • Southlake, TX
National Provider Identifier
1134497316
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11657 Issued in TX
Legal business name
STICE CHIROPRACTIC & WELLNESS CENTER
Practice address
500 N Carroll Ave
Ste. 100
Southlake, TX 76092-6410
Phone
(817) 488-6495
NPI assigned
Dec 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Dr. Kevin SticeNPI 1033414685
Title
Owner
Phone
(817) 488-6495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 11657 TX Primary

Addresses

Primary practice location

500 N Carroll Ave
Ste. 100
Southlake, TX 76092-6410

Mailing address

500 N Carroll Ave
Ste. 100
Southlake, TX 76092-6410
Phone (817) 488-6495

National Provider Directory

National Provider Directory

Locations

500 N Carroll Ave
Ste 100
Southlake, TX 76092
Phone (817) 488-6495

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1134497316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N CARROLL AVE",
            "address_2": "STE. 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926410",
            "telephone_number": "817-488-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CARROLL AVE",
            "address_2": "STE. 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926410",
            "telephone_number": "817-488-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STICE CHIROPRACTIC & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "STICE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-488-6495",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11657",
            "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 May 1, 2012; 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.