Provider Demographics
NPI:1568539112
Name:RICHARD CHATFIELD CHIROPRACTIC CLINIC, PA
Entity Type:Organization
Organization Name:RICHARD CHATFIELD CHIROPRACTIC CLINIC, PA
Other - Org Name:BACK & NECK CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:CHATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-283-6100
Mailing Address - Street 1:2803 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4812
Mailing Address - Country:US
Mailing Address - Phone:817-283-6100
Mailing Address - Fax:817-283-9536
Practice Address - Street 1:2803 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4812
Practice Address - Country:US
Practice Address - Phone:817-283-6100
Practice Address - Fax:817-283-9536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376635800OtherNPI TYPE 1
TX601691Medicare ID - Type Unspecified
TX376635800OtherNPI TYPE 1