Active NPI
Healthsource of Allen LLC
- Chiropractor
- Allen, TX
National Provider Identifier
1184991069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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 DirectoryLocations
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.
-
- Chiropractor
- Prosper, TX
- NPI 1306286745
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.