Provider Demographics
NPI:1578715140
Name:PROCTER FAMILY CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:PROCTER FAMILY CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PROCTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:254-773-1121
Mailing Address - Street 1:3411 MARKET LOOP
Mailing Address - Street 2:STE 110
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2773
Mailing Address - Country:US
Mailing Address - Phone:254-773-1121
Mailing Address - Fax:254-773-1185
Practice Address - Street 1:3411 MARKET LOOP
Practice Address - Street 2:STE 110
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2773
Practice Address - Country:US
Practice Address - Phone:254-773-1121
Practice Address - Fax:254-773-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF004722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606085OtherBCBS