Provider Demographics
NPI:1225799661
Name:GILES, JOHN EVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EVAN
Last Name:GILES
Suffix:
Gender:M
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 1969
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0034
Mailing Address - Country:US
Mailing Address - Phone:972-210-0033
Mailing Address - Fax:972-210-0034
Practice Address - Street 1:13988 DIPLOMAT DR STE 100C
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-8807
Practice Address - Country:US
Practice Address - Phone:972-210-0033
Practice Address - Fax:972-210-0034
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14984111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation