Provider Demographics
NPI:1649543455
Name:HARPER, JEFFREY QUENTIN (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:QUENTIN
Last Name:HARPER
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 1:1742 FM 2673
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133
Mailing Address - Country:US
Mailing Address - Phone:830-964-3032
Mailing Address - Fax:830-964-4460
Practice Address - Street 1:1742 FM 2673
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133
Practice Address - Country:US
Practice Address - Phone:830-964-3032
Practice Address - Fax:830-964-4460
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor