Mackie Dawayne Gourley Jr., CHIROPRACTOR

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

F0011681 Issued in TX

Practice address

190 E Stacy Rd Ste 306-397
Allen, TX 75002-8734

Phone

(469) 519-1282

NPI assigned

May 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1558898494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WATTERS RD STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135344",
            "telephone_number": "469-519-1282",
            "fax_number": "972-696-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E STACY RD STE 306-397",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750028734",
            "telephone_number": "469-519-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLEY",
        "first_name": "MACKIE",
        "middle_name": "DAWAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "F0011681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric A Gordon
• Kimberly D Goree, M.S. CCC-SLP
• Richard Goudeau Jr., MA, LMFT-S, LPC-S
• Tamela L Gough, D.D.S, M.S.
• Kayla Goumas
• Vandana Panda Goyle, M.D.
• Luc G Gradisar, DC
• Shanae Melee Graf, LPC-ASSOCIATE
• Chester F Graham, M.D.
• Pamela Graham, MLA, SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; 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.