NPIMap

Organization Active NPI

Healthsource of Frisco LLC

  • Chiropractor
  • Frisco, TX
National Provider Identifier
1699028084
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HEALTHSOURCE OF FRISCO LLC
Practice address
7010 Preston Rd
Suite 100
Frisco, TX 75034-5869
Phone
(469) 633-1155
NPI assigned
Oct 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
M. Brandon Pettke, D.C. PA
Title
President/Owner
Phone
(817) 291-1816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

7010 Preston Rd
Suite 100
Frisco, TX 75034-5869

Mailing address

7010 Preston Rd
Suite 100
Frisco, TX 75034-5869
Phone (469) 633-1155

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1699028084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 PRESTON RD",
            "address_2": "SUITE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345869",
            "telephone_number": "469-633-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 PRESTON RD",
            "address_2": "SUITE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345869",
            "telephone_number": "469-633-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF FRISCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "PETTKE",
        "authorized_official_first_name": "M. BRANDON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "817-291-1816",
        "authorized_official_credential": "D.C. PA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.