Provider Demographics
NPI:1689781106
Name:PARRISH, SCOTTY HOWARD (DC)
Entity Type:Individual
Prefix:
First Name:SCOTTY
Middle Name:HOWARD
Last Name:PARRISH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-2640
Mailing Address - Country:US
Mailing Address - Phone:806-791-4451
Mailing Address - Fax:806-791-4451
Practice Address - Street 1:4140 34TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-2640
Practice Address - Country:US
Practice Address - Phone:806-791-4451
Practice Address - Fax:806-791-4451
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC5909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
8242368OtherBLUE LINK ID NUMBER
TXU42368Medicare UPIN
8242368OtherBLUE LINK ID NUMBER