Provider Demographics
NPI:1073676318
Name:SHWALUK, LAURA F (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:F
Last Name:SHWALUK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 E PLANO PKWY STE 142
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-7523
Mailing Address - Country:US
Mailing Address - Phone:972-881-4343
Mailing Address - Fax:
Practice Address - Street 1:2540 E PLANO PKWY STE 142
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-7523
Practice Address - Country:US
Practice Address - Phone:972-881-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A7710OtherBCBSTX
TX00906TMedicare ID - Type UnspecifiedMEDICARE GROUP
TX8A7710OtherBCBSTX
TXU62587Medicare UPIN