Provider Demographics
NPI:1346362670
Name:JONES, LARRY DAVID (DC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:DAVID
Last Name:JONES
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 1:7236 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3653
Mailing Address - Country:US
Mailing Address - Phone:915-581-7001
Mailing Address - Fax:915-581-7603
Practice Address - Street 1:7236 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3653
Practice Address - Country:US
Practice Address - Phone:915-581-7001
Practice Address - Fax:915-581-7603
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5045111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88G836Medicare PIN