Provider Demographics
NPI:1639595226
Name:FAIRFIELD CHIROPRACTIC
Entity Type:Organization
Organization Name:FAIRFIELD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WILLMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-256-8100
Mailing Address - Street 1:16341 MUESCHKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5218
Mailing Address - Country:US
Mailing Address - Phone:281-256-8100
Mailing Address - Fax:281-256-8163
Practice Address - Street 1:16341 MUESCHKE RD STE 200
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5218
Practice Address - Country:US
Practice Address - Phone:281-256-8100
Practice Address - Fax:281-256-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU76932Medicare UPIN