Jay Bob Haney, D.C.
Individual provider Active NPI Chiropractor · Pecos, TX
NPI 1831190842 · NPPES record last updated Jun 30, 2014
Key facts
- NPI
- 1831190842
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 8354 (TX)
- Practice address
- 1309 W 3Rd St
Pecos, TX 79772-2826 - Phone
- (432) 445-4878
- Fax
- (432) 445-4835
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradshaw Chiropractic Center | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8354 | TX | Yes |
Addresses
Primary practice location
1309 W 3Rd St
Pecos, TX 79772-2826
Mailing address
1309 W 3Rd St
Pecos, TX 79772-2826
Phone (432) 445-4878
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176522401 | Medicaid | TX | |
| 608066 | Other | TX | BCBS |
Other providers in Pecos, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.