Provider Demographics
NPI:1750311163
Name:CARLEY-HARRIS, SHEILA MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MICHELLE
Last Name:CARLEY-HARRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4217 FAIRWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2454
Mailing Address - Country:US
Mailing Address - Phone:940-228-7512
Mailing Address - Fax:940-696-0475
Practice Address - Street 1:4217 FAIRWAY BLVD.
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-0444
Practice Address - Country:US
Practice Address - Phone:940-228-7512
Practice Address - Fax:940-696-0475
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176683401Medicaid
TX8G5331OtherBLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER
TX0006JFOtherBLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER
TX111N00000XOtherTAXONOMY NUMBER
TX1902090236OtherGROUP NPI NUMBER
TX111N00000XOtherTAXONOMY NUMBER
TX176683401Medicaid