Provider Demographics
NPI:1528538253
Name:JAIMES, GLORIA (DC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:JAIMES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6016 SW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-3502
Mailing Address - Country:US
Mailing Address - Phone:806-414-8165
Mailing Address - Fax:
Practice Address - Street 1:6016 SW 33RD AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-3502
Practice Address - Country:US
Practice Address - Phone:806-414-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty