Provider Demographics
NPI:1649201120
Name:SHAUGHN T. SMS D.C., P. C.
Entity Type:Organization
Organization Name:SHAUGHN T. SMS D.C., P. C.
Other - Org Name:ROLLING PLAINS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUGHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-773-2193
Mailing Address - Street 1:1501 COLUMBIA ST STE B
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79553-6882
Mailing Address - Country:US
Mailing Address - Phone:325-773-2193
Mailing Address - Fax:325-773-2194
Practice Address - Street 1:1501 COLUMBIA ST STE B
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:TX
Practice Address - Zip Code:79553-6882
Practice Address - Country:US
Practice Address - Phone:325-773-2193
Practice Address - Fax:325-773-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU74625Medicare UPIN
TX00563NMedicare ID - Type Unspecified