Provider Demographics
NPI:1639215296
Name:HAIGIS, ERICH M (PHD, DC)
Entity Type:Individual
Prefix:DR
First Name:ERICH
Middle Name:M
Last Name:HAIGIS
Suffix:
Gender:M
Credentials:PHD, DC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 810767
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75381-0767
Mailing Address - Country:US
Mailing Address - Phone:972-444-9485
Mailing Address - Fax:972-444-9485
Practice Address - Street 1:13740 MIDWAY RD
Practice Address - Street 2:SUITE 602
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4314
Practice Address - Country:US
Practice Address - Phone:972-786-5288
Practice Address - Fax:972-444-9485
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX9613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613064Medicare PIN