Provider Demographics
NPI:1699705913
Name:AWWAD, NADER JAMAL (DC)
Entity type:Individual
Prefix:DR
First Name:NADER
Middle Name:JAMAL
Last Name:AWWAD
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:PO BOX 151482
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-7482
Mailing Address - Country:US
Mailing Address - Phone:817-275-9249
Mailing Address - Fax:817-275-9273
Practice Address - Street 1:3810 S COOPER ST
Practice Address - Street 2:SUITE 122
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4149
Practice Address - Country:US
Practice Address - Phone:817-275-9249
Practice Address - Fax:817-275-9273
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
606225OtherBLUE CROSS/BLUE SHIELD
606225OtherBLUE CROSS/BLUE SHIELD