Provider Demographics
NPI:1457895237
Name:ADCOCK, WILLIAM CHAD (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHAD
Last Name:ADCOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 OLD JACKSONVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3378
Mailing Address - Country:US
Mailing Address - Phone:903-574-4440
Mailing Address - Fax:
Practice Address - Street 1:5524 OLD JACKSONVILLE HWY
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3378
Practice Address - Country:US
Practice Address - Phone:903-574-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13321OtherTEXAS BOARD OF CHIROPRACTIC EXAMINERS
TX13321OtherTEXAS BOARD OF CHIROPRACTIC EXAMINERS