Provider Demographics
NPI:1841296704
Name:WESTBROOK, RON W (DC)
Entity type:Individual
Prefix:DR
First Name:RON
Middle Name:W
Last Name:WESTBROOK
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 1:1700 W BUSINESS 380
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3232
Mailing Address - Country:US
Mailing Address - Phone:940-627-7811
Mailing Address - Fax:940-627-7814
Practice Address - Street 1:1700 W BUSINESS 380
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3232
Practice Address - Country:US
Practice Address - Phone:940-627-7811
Practice Address - Fax:940-627-7814
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6400111NN1001X, 111NS0005X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605030OtherPROVIDER NUMBER
TXU50283Medicare UPIN
TX8F0846Medicare PIN