Provider Demographics
NPI:1740281914
Name:WOODWARD, JONATHAN E (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:E
Last Name:WOODWARD
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 1:6310 LYNDON B JOHNSON FWY STE 115
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6424
Mailing Address - Country:US
Mailing Address - Phone:972-490-9888
Mailing Address - Fax:972-490-9830
Practice Address - Street 1:6310 LYNDON B JOHNSON FWY STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6424
Practice Address - Country:US
Practice Address - Phone:972-490-8888
Practice Address - Fax:972-490-9830
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10009303OtherAMERIGROUP (MEDICAID)
TX1950891OtherFIRST HEALTH
TX7035288OtherAETNA
TX8F6280OtherBLUE CROSS/ BLUE SHIELD
TX1511776-02Medicaid
TX13276OtherPARKLAND COMMUNITY HEALTH
TX13276OtherPARKLAND COMMUNITY HEALTH
TXP00045636Medicare ID - Type UnspecifiedRAILROAD
U83070Medicare UPIN