Provider Demographics
NPI:1003145640
Name:MEADOWS CHIROPRACTIC
Entity Type:Organization
Organization Name:MEADOWS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-987-9973
Mailing Address - Street 1:5646 MILTON ST
Mailing Address - Street 2:240
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3907
Mailing Address - Country:US
Mailing Address - Phone:972-987-9973
Mailing Address - Fax:
Practice Address - Street 1:5646 MILTON ST
Practice Address - Street 2:240
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-3907
Practice Address - Country:US
Practice Address - Phone:972-987-9973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty