Provider Demographics
NPI:1386781896
Name:KREJCI, TED A JR (DC)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:A
Last Name:KREJCI
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:THEODORE
Other - Middle Name:A
Other - Last Name:KREJCI
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4103 ESTERS RD APT 206
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-1462
Mailing Address - Country:US
Mailing Address - Phone:214-324-4002
Mailing Address - Fax:
Practice Address - Street 1:1303 W WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3030
Practice Address - Country:US
Practice Address - Phone:214-324-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor