Organization Active NPI

Lifetime Chiropractic, P.a.

  • Chiropractor
  • Garland, TX
National Provider Identifier
1700984796
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10312 Issued in TX
Legal business name
LIFETIME CHIROPRACTIC, P.A.
Practice address
630 W Interstate 30
Ste 600
Garland, TX 75043-5731
Phone
(972) 203-5800
Fax
(972) 203-5814
NPI assigned
Sep 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Darla Davis, D.C.
Title
President
Phone
(972) 203-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10312 TX Primary

Addresses

Primary practice location

630 W Interstate 30
Ste 600
Garland, TX 75043-5731

Mailing address

630 W Interstate 30
Ste 600
Garland, TX 75043-5731
Phone (972) 203-5800

Other identifiers 1

IdentifierTypeStateIssuer
0074NTOtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

630 W Interstate 30
Ste 600
Garland, TX 75043
Phone (972) 203-5800

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700984796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W INTERSTATE 30",
            "address_2": "STE 600",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435731",
            "telephone_number": "972-203-5800",
            "fax_number": "972-203-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W INTERSTATE 30",
            "address_2": "STE 600",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435731",
            "telephone_number": "972-203-5800",
            "fax_number": "972-203-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-203-5800",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0074NT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.