Colin Tkachuk

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

9771 Issued in TX

Legal business name

COLIN TKACHUK

Doing business as

Optimum Chiropractic and Wellness Center

Practice address

6224 Colleyville Blvd
Suite B
Colleyville, TX 76034-6276

Phone

(817) 481-9339

Fax

(817) 481-9669

NPI assigned

Sep 13, 2006

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Colin Tkachuk, DCNPI 1356529366

Title

Chiropractor

Phone

(817) 481-9339

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Optimum Chiropractic and Wellness Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colin Tkachuk, D.C.

  • Chiropractor
  • Colleyville, TX
  • NPI 1356529366
  NPD (past) Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1235233750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 COLLEYVILLE BLVD",
            "address_2": "SUITE B",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346276",
            "telephone_number": "817-481-9339",
            "fax_number": "817-481-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 COLLEYVILLE BLVD",
            "address_2": "SUITE B",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346276",
            "telephone_number": "817-481-9339",
            "fax_number": "817-481-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIN TKACHUK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "TKACHUK",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "817-481-9339",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROF LICENSE #",
            "identifier": "9771",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "608079",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00366997",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan M Cizmas, MA, LPC
• Chelsey Clark
• Tamera D Clark, ND, SLP
• Tara Lowe Clark, MD
• Kimberly Coffee, AGPCNP
• Collaborative Counselor Enterprises, PLLC
• Collaborative Wellness Center LLC
• Colleyville Body Focus Spa and Wellness Dba Juvia Med Spa
• Colleyville Body Focus Wellness Clinic, LLC (Juvia Med Spa)
• Colleyville Chiropractic, PLLC

• Chiropractor in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.