Provider Demographics
NPI:1003971086
Name:WELTY, JEFFRY CHAD (DC)
Entity Type:Individual
Prefix:
First Name:JEFFRY
Middle Name:CHAD
Last Name:WELTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7304 W 34TH AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1400
Mailing Address - Country:US
Mailing Address - Phone:806-463-3400
Mailing Address - Fax:806-463-3402
Practice Address - Street 1:7304 W 34TH AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1400
Practice Address - Country:US
Practice Address - Phone:806-463-3400
Practice Address - Fax:806-463-3402
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609191OtherBLUE CROSS
TX0078255OtherBLUE LINK
TX0078255OtherBLUE LINK
TXU73171Medicare UPIN