Provider Demographics
NPI:1467474890
Name:HIMMELSEHR, CRAIG RONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RONALD
Last Name:HIMMELSEHR
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 1:1530 FOREST LN S
Mailing Address - Street 2:SUITE H
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7950
Mailing Address - Country:US
Mailing Address - Phone:972-272-8769
Mailing Address - Fax:972-272-8920
Practice Address - Street 1:1530 FOREST LN S
Practice Address - Street 2:SUITE H
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7950
Practice Address - Country:US
Practice Address - Phone:972-272-8769
Practice Address - Fax:972-272-8920
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8299111N00000X
TX4000111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician