Provider Demographics
NPI:1720310857
Name:NIXON, ELIZABETH L (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:L
Last Name:NIXON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:546 E FM 2410 RD STE B
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-5692
Mailing Address - Country:US
Mailing Address - Phone:254-681-1544
Mailing Address - Fax:877-229-7069
Practice Address - Street 1:546 E FM 2410 RD STE B
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5692
Practice Address - Country:US
Practice Address - Phone:254-681-1544
Practice Address - Fax:877-229-7069
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608798OtherBCBS TX
TX292326OtherMEDICARE INDIVIDUAL PTAN