Provider Demographics
NPI:1255437000
Name:TROTTIER, JANINE R (DC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:R
Last Name:TROTTIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 FOREST LANE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:972-239-6932
Mailing Address - Fax:972-239-6935
Practice Address - Street 1:5925 FOREST LANE
Practice Address - Street 2:SUITE 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:972-239-6932
Practice Address - Fax:972-239-6935
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K3340OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX601877Medicare PIN
TX8K3340OtherBLUE CROSS BLUE SHIELD OF TEXAS