Provider Demographics
NPI:1225211303
Name:TROCARD, JOEHANNAH DORITA (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEHANNAH
Middle Name:DORITA
Last Name:TROCARD
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:PO BOX 5128
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-9128
Mailing Address - Country:US
Mailing Address - Phone:214-941-6262
Mailing Address - Fax:214-941-6224
Practice Address - Street 1:2301 S HAMPTON RD
Practice Address - Street 2:700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1650
Practice Address - Country:US
Practice Address - Phone:214-941-6262
Practice Address - Fax:214-941-6224
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R3370OtherBLUE CROSS BLUE SHIELD
TXV08108Medicare UPIN
TX8R3370OtherBLUE CROSS BLUE SHIELD