Organization Active NPI

Healthsource of Allen LLC

  • Chiropractor
  • Allen, TX
National Provider Identifier
1184991069
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HEALTHSOURCE OF ALLEN LLC
Practice address
1546 Stacy Rd
Ste 170
Allen, TX 75002-8726
Phone
(972) 359-1362
Fax
(972) 359-1376
NPI assigned
Nov 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
M Brandon Pettke, DC
Title
Manager
Phone
(972) 359-1362

Specialties & licenses 1

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

Addresses

Primary practice location

1546 Stacy Rd
Ste 170
Allen, TX 75002-8726

Mailing address

1546 Stacy Rd
Ste 170
Allen, TX 75002-8726
Phone (972) 359-1362

National Provider Directory

National Provider Directory

Locations

1546 Stacy Rd
Ste 1
Allen, TX 75002
Phone (972) 359-1362

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": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1184991069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 STACY RD",
            "address_2": "STE 170",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750028726",
            "telephone_number": "972-359-1362",
            "fax_number": "972-359-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 STACY RD",
            "address_2": "STE 170",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750028726",
            "telephone_number": "972-359-1362",
            "fax_number": "972-359-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF ALLEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "PETTKE",
        "authorized_official_first_name": "M BRANDON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-359-1362",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.