Provider Demographics
NPI:1396003059
Name:GAFKEN CHIROPRACTIC CENTRE, INC.
Entity Type:Organization
Organization Name:GAFKEN CHIROPRACTIC CENTRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAFKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-646-4664
Mailing Address - Street 1:PO BOX 2237
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-2237
Mailing Address - Country:US
Mailing Address - Phone:325-646-4664
Mailing Address - Fax:325-643-5861
Practice Address - Street 1:3002 HIGHWAY 377 S
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5122
Practice Address - Country:US
Practice Address - Phone:325-646-4664
Practice Address - Fax:325-643-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13363Medicaid
TX13363Medicaid