| Juan C Vidales, DC | |
|
850 S Greenville Ave Ste 104, Richardson, TX 75081-5046 | |
| (972) 644-6336 | |
| (972) 644-7247 |
| Full Name | Juan C Vidales |
|---|---|
| Gender | Male |
| Speciality | Chiropractic |
| Experience | 6 Years |
| Location | 850 S Greenville Ave Ste 104, Richardson, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023602406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 9039 (Arizona) | Secondary |
| 111N00000X | Chiropractor | 15543 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Traxler Chiropractic Pa | 7113820077 | 4 |
| Turner Chiropractic | 7810064193 | 2 |
| Provider Name | Turner Chiropractic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1245402809 PECOS PAC ID: 7810064193 Enrollment ID: O20080929000512 |
| Mailing Address | Practice Location Address |
|---|---|
| Juan C Vidales, DC 850 S Greenville Ave Ste 104, Richardson, TX 75081-5046 Ph: (972) 644-6336 | Juan C Vidales, DC 850 S Greenville Ave Ste 104, Richardson, TX 75081-5046 Ph: (972) 644-6336 |
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