Individual
DR. JEFFREY SHAWN STANDIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3314 W KIEST BLVD, DALLAS, TX 75233-2102
(214) 623-0505
(214) 623-0520
Mailing address
PO BOX 211251, DALLAS, TX 75211-4304
(214) 623-0505
(214) 623-0520
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8482
TX
111NN1001X
Nutrition Chiropractor
8482
TX
111NP0017X
Pediatric Chiropractor
8482
TX
111NR0200X
Radiology Chiropractor
8482
TX
111NR0400X
Rehabilitation Chiropractor
8482
TX
111NS0005X
Sports Physician Chiropractor
8482
TX
111NX0800X
Orthopedic Chiropractor
8482
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106750
AMERIGROUP
TX
01
—
10862
PARKLAND
TX
05
—
146332501
—
TX
01
—
7691324
AETNA
TX
01
—
8B8920
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/30/2006
Last updated
12/12/2008
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