Healthsource of Mansfield Texas LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

HEALTHSOURCE OF MANSFIELD TEXAS LLC

Practice address

121 W Debbie LN
Ste 115
Mansfield, TX 76063-8941

Phone

(682) 518-9393

Fax

(682) 518-9398

NPI assigned

Dec 9, 2011

Organization subpart

No

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

(682) 518-9393

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Brandon Pettke, DC

  • Chiropractor
  • Burleson, TX
  • NPI 1730107889
  NPD (past)

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1629346382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W DEBBIE LN",
            "address_2": "STE 115",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638941",
            "telephone_number": "682-518-9393",
            "fax_number": "682-518-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W DEBBIE LN",
            "address_2": "STE 115",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638941",
            "telephone_number": "682-518-9393",
            "fax_number": "682-518-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF MANSFIELD TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "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": "682-518-9393",
        "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": []
}

• Healing Gardens Home Health Care
• Healing Hope Behavioral Clinic LLC
• Health Gardens Home Care LLC
• Health Imaging Partners, LLC
• Health Imaging Partners, LLC
• Healthsource of Mansfield Texas LLC
• Healthtexas Provider Network
• Healthtexas Provider Network
• Healthtexas Provider Network
• Healthy Body Chiropractic PLLC

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

• 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.