Maxwell Chiropractic Services, P.a.
Organization Active NPI Chiropractor · Borger, TX
NPI 1669660718 · NPPES record last updated Oct 12, 2007
Key facts
- NPI
- 1669660718
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 10696 (TX)
- Legal business name
- MAXWELL CHIROPRACTIC SERVICES, P.A.
- Practice address
- 619 Deahl St
Borger, TX 79007-3519 - Phone
- (806) 273-2415
- Fax
- (806) 273-2715
- NPI assigned
- Oct 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jamey Ray Maxwell, D.C.
- Title
- President/Chiropractor
- Phone
- (806) 273-2415
Practitioners 1
-
Jamey Ray Maxwell, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080425000314 | TX | Part B Supplier - Clinic/Group Practice | 9234217639 |
Receives reassigned benefits from 1 practitioner Practice locations: Borger, TX |
National Provider Directory
Locations
619 Deahl St
Borger, TX 79007
Phone (806) 273-2415
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 10696 | TX | Yes |
Addresses
Primary practice location
619 Deahl St
Borger, TX 79007-3519
Mailing address
619 Deahl St
Borger, TX 79007-3519
Phone (806) 273-2415
Other names
- Revelations Chiropractic
Other providers in Borger, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.