Provider Demographics
NPI:1407155633
Name:W.C. LAROCK, D.C. , P.C.
Entity Type:Organization
Organization Name:W.C. LAROCK, D.C. , P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILFORD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LAROCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-875-0050
Mailing Address - Street 1:6330 N MESA ST
Mailing Address - Street 2:STE D
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4564
Mailing Address - Country:US
Mailing Address - Phone:915-875-0050
Mailing Address - Fax:915-875-0068
Practice Address - Street 1:6330 N MESA ST
Practice Address - Street 2:STE D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4564
Practice Address - Country:US
Practice Address - Phone:915-875-0050
Practice Address - Fax:915-875-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1801199419OtherINDIVIDUAL NPI