Provider Demographics
NPI:1104920503
Name:MERIWETHER, CHAD L (BS DC FIAMA)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:L
Last Name:MERIWETHER
Suffix:
Gender:M
Credentials:BS DC FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MIKE THORNTON CT
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76088-1121
Mailing Address - Country:US
Mailing Address - Phone:254-485-8889
Mailing Address - Fax:
Practice Address - Street 1:6900 E. I-20 SERVICE RD.
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-4467
Practice Address - Country:US
Practice Address - Phone:254-485-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7032111NR0400X, 171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX07032OtherTEXAS BOARD OF CHIROPRACTIC EXAMINERS
TX605627OtherBCBS