Provider Demographics
NPI:1376727198
Name:ZWIERSTRA, JEFFREY ALAN (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:ZWIERSTRA
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 1:5310 N TARRANT PKWY STE 132
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7300
Mailing Address - Country:US
Mailing Address - Phone:817-849-2165
Mailing Address - Fax:817-849-2208
Practice Address - Street 1:5310 N TARRANT PKWY STE 132
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-7300
Practice Address - Country:US
Practice Address - Phone:817-849-2165
Practice Address - Fax:817-849-2208
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor