Provider Demographics
NPI:1184370835
Name:100 CHIRO GIRDY PLLC
Entity type:Organization
Organization Name:100 CHIRO GIRDY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-737-4222
Mailing Address - Street 1:6326 YORKTOWN BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-5861
Mailing Address - Country:US
Mailing Address - Phone:361-737-4222
Mailing Address - Fax:
Practice Address - Street 1:6326 YORKTOWN BLVD STE 7
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-5861
Practice Address - Country:US
Practice Address - Phone:361-737-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health