Provider Demographics
NPI:1205061637
Name:HADDOCK CHIROPRACTIC & WELLNESS CENTER PLLC
Entity type:Organization
Organization Name:HADDOCK CHIROPRACTIC & WELLNESS CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HADDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-794-4009
Mailing Address - Street 1:3311 81ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2008
Mailing Address - Country:US
Mailing Address - Phone:806-794-4009
Mailing Address - Fax:
Practice Address - Street 1:3311 81ST ST STE B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2008
Practice Address - Country:US
Practice Address - Phone:806-794-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A4615Medicare PIN