Provider Demographics
NPI:1104835438
Name:BOOTH, CAROL W (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:W
Last Name:BOOTH
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 W PARK ROW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3502
Mailing Address - Country:US
Mailing Address - Phone:817-460-4644
Mailing Address - Fax:817-460-4641
Practice Address - Street 1:1621 W PARK ROW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3502
Practice Address - Country:US
Practice Address - Phone:817-460-4644
Practice Address - Fax:817-460-4641
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
86M322Medicare PIN