Provider Demographics
NPI:1033561360
Name:EZELL, ALISON (DC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:EZELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2901 INDIANA BLVD
Mailing Address - Street 2:APT 467
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1520
Mailing Address - Country:US
Mailing Address - Phone:913-850-9028
Mailing Address - Fax:
Practice Address - Street 1:6301 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3922
Practice Address - Country:US
Practice Address - Phone:972-392-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor