Provider Demographics
NPI:1053669770
Name:CAMERON CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:CAMERON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-504-9000
Mailing Address - Street 1:5605 VIRGINIA PARKWAY
Mailing Address - Street 2:SUITE #5
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5533
Mailing Address - Country:US
Mailing Address - Phone:214-504-9000
Mailing Address - Fax:214-504-9051
Practice Address - Street 1:5605 VIRGINIA PARKWAY
Practice Address - Street 2:SUITE #5
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5533
Practice Address - Country:US
Practice Address - Phone:214-504-9000
Practice Address - Fax:214-504-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610945Medicare PIN