Provider Demographics
NPI:1558545186
Name:WALNUT HILL CHIROPRACTIC
Entity Type:Organization
Organization Name:WALNUT HILL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-956-9977
Mailing Address - Street 1:2860 WALNUT HILL LN
Mailing Address - Street 2:SUITE 114
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5729
Mailing Address - Country:US
Mailing Address - Phone:214-956-9977
Mailing Address - Fax:214-956-9977
Practice Address - Street 1:2860 WALNUT HILL LN
Practice Address - Street 2:SUITE 114
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-5729
Practice Address - Country:US
Practice Address - Phone:214-956-9977
Practice Address - Fax:214-956-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00J58AMedicare PIN
U31618Medicare UPIN