Provider Demographics
NPI:1992762686
Name:BAGLEY, JARROD LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:JARROD
Middle Name:LYNN
Last Name:BAGLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11905 FM 2244 RD
Mailing Address - Street 2:STE 110
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5396
Mailing Address - Country:US
Mailing Address - Phone:512-263-0040
Mailing Address - Fax:512-263-0026
Practice Address - Street 1:3821 JUNIPER TRCE
Practice Address - Street 2:STE. 207
Practice Address - City:BEE CAVES
Practice Address - State:TX
Practice Address - Zip Code:78738-5506
Practice Address - Country:US
Practice Address - Phone:512-263-0040
Practice Address - Fax:512-263-0026
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor