Provider Demographics
NPI:1083759526
Name:ALVES, NANCY ELLIS (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELLIS
Last Name:ALVES
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 1:3633 BROADWAY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1671
Mailing Address - Country:US
Mailing Address - Phone:972-864-0539
Mailing Address - Fax:972-864-8888
Practice Address - Street 1:3633 BROADWAY BLVD STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1671
Practice Address - Country:US
Practice Address - Phone:972-864-0539
Practice Address - Fax:972-864-8888
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752131220OtherTAX ID #
TX752131220OtherTAX ID #
TXUT13168Medicare UPIN