Provider Demographics
NPI:1184694606
Name:LEDBETTER, WILLIAM HARRY III (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARRY
Last Name:LEDBETTER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2376 LAVON DR
Mailing Address - Street 2:STE. 134
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9037
Mailing Address - Country:US
Mailing Address - Phone:214-703-9800
Mailing Address - Fax:214-703-8001
Practice Address - Street 1:2376 LAVON DR
Practice Address - Street 2:STE. 134
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9037
Practice Address - Country:US
Practice Address - Phone:214-703-9800
Practice Address - Fax:214-703-8001
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1434177-01Medicaid
TXU31433Medicare UPIN
TX603881Medicare ID - Type Unspecified