Provider Demographics
NPI:1477316016
Name:FALLER, MIGUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
Last Name:FALLER
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 1:1009 14TH ST APT 244
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-0068
Mailing Address - Country:US
Mailing Address - Phone:210-758-7319
Mailing Address - Fax:
Practice Address - Street 1:1970 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2908
Practice Address - Country:US
Practice Address - Phone:214-544-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor