WCCW Crockett, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WCCW CROCKETT, LLC

Practice address

2200 N 4TH St
Crockett, TX 75835-5337

Phone

(936) 546-0070

NPI assigned

Jul 8, 2019

Organization subpart

No

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

Authorized official

Name

Brittany Leslie

Title

Office Manager

Phone

(903) 948-0845

Specialties & licenses 1

Addresses

Other names 1

• Willow Creek Chiropractic & Wellness Doing business as

Practitioners 1

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

• Zachary Zane Leslie, DC

  • Chiropractor
  • Palestine, TX
  • NPI 1093756769
  NPD

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1881256170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21721 PAGOSA RANCH RD",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757574109",
            "telephone_number": "903-948-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N 4TH ST",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758355337",
            "telephone_number": "936-546-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WCCW CROCKETT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "LESLIE",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-948-0845"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Creek Chiropractic & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.