Provider Demographics
NPI:1477683555
Name:BOOKER, SHELLEY (DC)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:BOOKER
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 1:4041 W WHEATLAND RD
Mailing Address - Street 2:#156, PMB 487
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4063
Mailing Address - Country:US
Mailing Address - Phone:214-986-6096
Mailing Address - Fax:866-670-9016
Practice Address - Street 1:4041 W WHEATLAND RD
Practice Address - Street 2:#156, PMB 487
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4063
Practice Address - Country:US
Practice Address - Phone:214-986-6096
Practice Address - Fax:866-670-9016
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor