Provider Demographics
NPI:1467510511
Name:MORRELL, ROY J (DC)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:J
Last Name:MORRELL
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 1:3480 FANNIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701
Mailing Address - Country:US
Mailing Address - Phone:409-832-7776
Mailing Address - Fax:409-832-7405
Practice Address - Street 1:3480 FANNIN ST STE C
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-832-7776
Practice Address - Fax:409-832-7405
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605469Medicare ID - Type Unspecified
U62005Medicare UPIN