Provider Demographics
NPI:1972728319
Name:JH CHIROPRACTIC
Entity Type:Organization
Organization Name:JH CHIROPRACTIC
Other - Org Name:WILLOW BEND CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HEPTIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-608-4411
Mailing Address - Street 1:5904 CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5925
Mailing Address - Country:US
Mailing Address - Phone:972-608-4411
Mailing Address - Fax:972-608-4412
Practice Address - Street 1:5904 CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5925
Practice Address - Country:US
Practice Address - Phone:972-608-4411
Practice Address - Fax:972-608-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606245OtherBCBS PROVIDER ID #
TX606245OtherBCBS PROVIDER ID #
TX609519Medicare ID - Type Unspecified