Provider Demographics
NPI:1568649515
Name:AVERY CHIROPRACTIC
Entity Type:Organization
Organization Name:AVERY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-624-6644
Mailing Address - Street 1:5204 S COLONY BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2347
Mailing Address - Country:US
Mailing Address - Phone:972-624-6644
Mailing Address - Fax:972-624-6655
Practice Address - Street 1:5204 S COLONY BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2347
Practice Address - Country:US
Practice Address - Phone:972-624-6644
Practice Address - Fax:972-624-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609152Medicare PIN