Provider Demographics
NPI:1427155068
Name:JOHNS FAMILY CHIROPRACTIC CORP
Entity type:Organization
Organization Name:JOHNS FAMILY CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-933-1381
Mailing Address - Street 1:3316 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0703
Mailing Address - Country:US
Mailing Address - Phone:866-933-1381
Mailing Address - Fax:972-704-2886
Practice Address - Street 1:3316 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0703
Practice Address - Country:US
Practice Address - Phone:866-933-1381
Practice Address - Fax:972-704-2886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S3180OtherBCBS
TXP00199466OtherMEDICARE RAILROAD
TXP00199466OtherMEDICARE RAILROAD
TX8S3180OtherBCBS