Provider Demographics
NPI:1467514968
Name:JAWHARI, KALED (DC)
Entity Type:Individual
Prefix:
First Name:KALED
Middle Name:
Last Name:JAWHARI
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 1:1010 N ELM ST STE C
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-6905
Mailing Address - Country:US
Mailing Address - Phone:940-566-6645
Mailing Address - Fax:940-566-6634
Practice Address - Street 1:1010 N ELM ST STE C
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-6905
Practice Address - Country:US
Practice Address - Phone:940-566-6645
Practice Address - Fax:940-566-6634
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU92987Medicare UPIN
TX00471UMedicare ID - Type Unspecified