NPIMap

Organization Active NPI

Glaze Chiropractic Clinic

  • Chiropractor
  • Gilmer, TX
National Provider Identifier
1215934682
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0017CC Issued in TX
Legal business name
GLAZE CHIROPRACTIC CLINIC
Practice address
1026 Titus St
Gilmer, TX 75644-3514
Phone
(903) 843-5643
Fax
(903) 843-4403
NPI assigned
Jun 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Dr. Randal L McDaniel, DCNPI 1437156643
Title
Owner
Phone
(903) 843-5643

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X 0017CC TX Primary

Addresses

Primary practice location

1026 Titus St
Gilmer, TX 75644-3514

Mailing address

PO Box 949
Gilmer, TX 75644-0949
Phone (903) 843-5643

National Provider Directory

National Provider Directory

Locations

1026 Titus St
Gilmer, TX 75644
Phone (214) 843-5643

Practitioners & affiliated clinicians

Practitioners 2

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": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1215934682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756440949",
            "telephone_number": "903-843-5643",
            "fax_number": "903-843-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 TITUS ST",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756443514",
            "telephone_number": "903-843-5643",
            "fax_number": "903-843-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAZE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-843-5643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "0017CC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilmer, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.