Provider Demographics
NPI:1831313485
Name:PRICE, JEFFREY R (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:PRICE
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:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:HEMPHILL
Mailing Address - State:TX
Mailing Address - Zip Code:75948-1000
Mailing Address - Country:US
Mailing Address - Phone:409-787-2424
Mailing Address - Fax:409-787-2748
Practice Address - Street 1:2025 HIGHWAY 83 WEST
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948
Practice Address - Country:US
Practice Address - Phone:409-787-2424
Practice Address - Fax:409-787-2748
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8914111NI0013X, 111NN1001X, 111NR0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606677OtherBCBS OF TEXAS
TX610147Medicare PIN