Provider Demographics
NPI:1558609057
Name:SOUTHALL CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SOUTHALL CHIROPRACTIC, PLLC
Other - Org Name:BELINDA J SOUTHALL, DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SOUTHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-854-2724
Mailing Address - Street 1:4433 LOOP 322
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-8056
Mailing Address - Country:US
Mailing Address - Phone:325-665-2975
Mailing Address - Fax:
Practice Address - Street 1:4433 LOOP 322
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-8056
Practice Address - Country:US
Practice Address - Phone:325-793-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty