Provider Demographics
NPI:1255133997
Name:BOOKER, XAVIER TYLER
Entity type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:TYLER
Last Name:BOOKER
Suffix:
Gender:
Credentials:
Other - Prefix:MR
Other - First Name:TYLER
Other - Middle Name:XAVIER
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:6224 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6288
Mailing Address - Country:US
Mailing Address - Phone:919-544-8881
Mailing Address - Fax:
Practice Address - Street 1:6224 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6288
Practice Address - Country:US
Practice Address - Phone:919-544-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor