Provider Demographics
NPI:1407002306
Name:CARMACK, BILLY (DC)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:
Last Name:CARMACK
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 1:200 CONTINENTAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8977
Mailing Address - Country:US
Mailing Address - Phone:972-899-9818
Mailing Address - Fax:972-899-9819
Practice Address - Street 1:200 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8977
Practice Address - Country:US
Practice Address - Phone:972-899-9818
Practice Address - Fax:972-899-9819
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor