Provider Demographics
NPI:1518710235
Name:O'FLAHERTY, JEFFREY DANIEL (DX)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DANIEL
Last Name:O'FLAHERTY
Suffix:
Gender:M
Credentials:DX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 SAM RAYBURN HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2685
Mailing Address - Country:US
Mailing Address - Phone:469-861-5434
Mailing Address - Fax:
Practice Address - Street 1:2231 SAM RAYBURN HWY STE 200
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2685
Practice Address - Country:US
Practice Address - Phone:469-861-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor