Provider Demographics
NPI:1649448283
Name:JOHN H RIGGS III
Entity type:Organization
Organization Name:JOHN H RIGGS III
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:432-570-8792
Mailing Address - Street 1:4610 N GARFIELD ST STE B4
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2652
Mailing Address - Country:US
Mailing Address - Phone:432-570-8792
Mailing Address - Fax:432-686-3931
Practice Address - Street 1:4610 N GARFIELD ST STE B4
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2652
Practice Address - Country:US
Practice Address - Phone:432-570-8792
Practice Address - Fax:432-686-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU54907Medicare UPIN
TX00003SMedicare PIN
TX83044EMedicare PIN