Provider Demographics
NPI:1366589764
Name:ADAMS, RONALD W (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:ADAMS
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 1:6900 W I 40 STE 180
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2522
Mailing Address - Country:US
Mailing Address - Phone:330-953-0705
Mailing Address - Fax:
Practice Address - Street 1:6900 W I 40 STE 180
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2522
Practice Address - Country:US
Practice Address - Phone:806-420-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1849111N00000X
OH4101111N00000X
TX13259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381535800Medicaid
FL58796BOtherBLUE CROSS BLUE SHIELD
FLK5231Medicare ID - Type Unspecified
FL381535800Medicaid