Eighteen95, Pa is a Chiropractor in Grapevine, Texas. Eighteen95, Pa practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Eighteen95, Pa is 1205009412. The last update date is 2013-10-14.
Eighteen95, Pa's current location address is 3500 William D. Tate, Grapevine, Texas. You can contact this provider via phone number 8174214775 and fax number 8174214303. The mailing address for Eighteen95, Pa is 3500 William D. Tate, Grapevine, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eighteen95, Pa |
|---|---|
| Address | 3500 William D. Tate, Grapevine, Texas |
| Phone Number | 8174214775 |
| Fax Number | 8174214303 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Grady Lynn Meredith |
| Credentials | DC |
| Telephone Number | 8174214775 |
NPI Number Detail
| NPI Number | 1205009412 |
|---|---|
| Provider Enumeration Date | 2008-04-09 |
| Last Updated Date | 2013-10-14 |
Provider Mailing Address Detail
| Address | 3500 William D. Tate |
|---|---|
| City | Grapevine |
| State | Texas (TX) |
| Post Code | 76051 |
| Phone Number | 8174214775 |
| Fax Number | 8174214303 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 9378 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 608860 | TX | BCBS | |
| V115395 | TX | INTEGRATED HEALTH PLAN | |
| 8BB730 | TX | BCBS |
Post Comment/ Review Below
What is the Eighteen95, Pa's unique identification number?
The Eighteen95, Pa has been assigned the NPI (National Provider Identifier) Number 1205009412 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Eighteen95, Pa located?
The Eighteen95, Pa is located at 3500 William D. Tate, Grapevine, TX 76051.
What is Eighteen95, Pa's specialized field of practice, and what is the corresponding taxonomy classification code?
The Eighteen95, Pa's area of specialization is Chiropractor, and the corresponding taxonomy code that categorizes this field of practice is 111N00000X.
On what date did the Eighteen95, Pa receive its 1205009412 assignment from the Centers for Medicare & Medicaid Services?
The Eighteen95, Pa was assigned its 1205009412 by the Centers for Medicare & Medicaid Services on 2008-04-09.
When was the information regarding Eighteen95, Pa, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Eighteen95, Pa, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2013-10-14.