Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 111NS0005X | Chiropractor | Sports Physician | 9511 | TEXAS | No |
| 2 | 111NR0400X | Chiropractor | Rehabilitation | 09511 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 013453 | OTHER | NEW YORK | CHIROPRACTIC LICENSE |
| 2 | 3107 | OTHER | TENNESSEE | CHIROPRACTIC LICENSE |
| 3 | 33637 | OTHER | CALIFORNIA | CHIROPRACTIC LICENSE |
| 4 | CHIA-2052 | OTHER | IDAHO | CHIROPRACTIC LICENSE |
| 5 | DC-1505-0 | OTHER | HAWAII | CHIROPRACTIC LICENSE |
| 6 | HCSFGARRETT | OTHER | KANSAS | CHIROPRACTIC LICENSE |
| 7 | TS0000531 | OTHER | INDIANA | CHIROPRACTIC LICENSE |
| 8 | 01-06123 | OTHER | KANSAS | CHIROPRACTIC LICENSE |
| 9 | 16276 | OTHER | ARKANSAS | CHIROPRACTIC LICENSE |
| 10 | 2668 | OTHER | ALABAMA | CHIROPRACTIC LICENSE |
| 11 | 8999 | OTHER | ARIZONA | CHIROPRACTIC LICENSE |
| 12 | CHIR010454 | OTHER | GEORGIA | CHIROPRACTIC LICENSE |
| 13 | 1141 | OTHER | NORTH DAKOTA | CHIROPRACTIC LICENSE |
| 14 | 1916 | OTHER | LOUISIANA | CHIROPRACTIC LICENSE |
| 15 | 4665 | OTHER | SOUTH CAROLINA | CHIROPRACTIC LICENSE |
| 16 | B01896 | OTHER | NEVADA | CHIROPRACTIC LICENSE |
| 17 | CH030223 | OTHER | DISTRICT OF COLUMBIA | CHIROPRACTIC LICENSE |
| 18 | DCP00685 | OTHER | RHODE ISLAND | CHIROPRACTIC LICENSE |
| 19 | 038.013637 | OTHER | ILLINOIS | CHIROPRACTIC LICENSE |
| 20 | 08003234A | OTHER | INDIANA | CHIROPRACTIC LICENSE |
| 21 | 09511 | OTHER | TEXAS | CHIROPRACTIC LICENSE |
| 22 | 1080 | OTHER | NEW HAMPSHIRE | CHIROPRACTIC LICENSE |
| 23 | 2216 | OTHER | CONNECTICUT | CHIROPRACTIC LICENSE |
| 24 | 2301011079 | OTHER | MICHIGAN | CHIROPRACTIC LICENSE |
| 25 | CH13333 | OTHER | FLORIDA | CHIROPRACTIC LICENSE |
| 26 | CH61104769 | OTHER | WASHINGTON | CHIROPRACTIC LICENSE |
| 27 | CR2677 | OTHER | MAINE | CHIROPRACTIC LICENSE |
| 28 | DC2260 | OTHER | NEW MEXICO | CHIROPRACTIC LICENSE |
| 29 | 001337 | OTHER | MISSISSIPPI | CHIROPRACTIC LICENSE |
| 30 | 006.0134151 | OTHER | VERMONT | CHIROPRACTIC LICENSE |
| 31 | 105973 | OTHER | IOWA | CHIROPRACTIC LICENSE |
| 32 | 11936522-1202 | OTHER | UTAH | CHIROPRACTIC LICENSE |
| 33 | 2020040067 | OTHER | MISSOURI | CHIROPRACTIC LICENSE |
| 34 | 5665-12 | OTHER | WISCONSIN | CHIROPRACTIC LICENSE |
| 35 | CHI-CHI-LIC-6710 | OTHER | MONTANA | CHIROPRACTIC LICENSE |
| 36 | 1405 | OTHER | SOUTH DAKOTA | CHIROPRACTIC LICENSE |
| 37 | 265421 | OTHER | KENTUCKY | CHIROPRACTIC LICENSE |
| 38 | 5245 | OTHER | NORTH CAROLINA | CHIROPRACTIC LICENSE |
| 39 | CH10242 | OTHER | FLORIDA | CHIROPRACTIC LICENSE |
| 40 | CHR.0006829 | OTHER | COLORADO | CHIROPRACTIC LICENSE |
| 41 | 0104557701 | OTHER | VIRGINIA | CHIROPRACTIC LICENSE |
| 42 | 04079 | OTHER | MARYLAND | CHIROPRACTIC LICENSE |
| 43 | 2070 | OTHER | NEBRASKA | CHIROPRACTIC LICENSE |
| 44 | DC-05024 | OTHER | OHIO | CHIROPRACTIC LICENSE |
| 45 | 3735 | OTHER | MASSACHUSETTS | CHIROPRACTIC LICENSE |
| 46 | 3894 | OTHER | OKLAHOMA | CHIROPRACTIC LICENSE |
| 47 | 38MC00776800 | OTHER | NEW JERSEY | CHIROPRACTIC LICENSE |
| 48 | 6852 | OTHER | MINNESOTA | CHIROPRACTIC LICENSE |
| 49 | DC011648 | OTHER | PENNSYLVANIA | CHIROPRACTIC LICENSE |
| 50 | F1-0011043 | OTHER | DELAWARE | CHIROPRACTIC LICENSE |
