Provider Demographics
NPI:1548606585
Name:MID VALLEY CHIROPRACTIC
Entity type:Organization
Organization Name:MID VALLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:D C
Authorized Official - Phone:956-399-7200
Mailing Address - Street 1:621 S TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6221
Mailing Address - Country:US
Mailing Address - Phone:956-647-5054
Mailing Address - Fax:956-647-5843
Practice Address - Street 1:621 S TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6221
Practice Address - Country:US
Practice Address - Phone:956-647-5054
Practice Address - Fax:956-647-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H9255OtherBLUECROSS/BLUESHIELD
TX001889701Medicaid
TX605348Medicare PIN
TXU59553Medicare UPIN