Organization
ERIC G. RUSSELL
Active
Other names
Beacon Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC GLENN RUSSELL DC (DOCTOR)
(903) 886-3100
Entity
Organization
Contact information
Practice address
1205 WASHINGTON ST, COMMERCE, TX 75428-2613
(903) 886-3100
(903) 886-3177
Mailing address
1205 WASHINGTON ST, COMMERCE, TX 75428-2613
(903) 886-3100
(903) 886-3177
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9291
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033320593
NPI
TX
01
—
1336183904
NPI
TX
Enumeration date
05/25/2007
Last updated
05/23/2009
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