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Individual

DR. JEFFRY VINCENT POPHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
929 LOOP 332, LIBERTY HILL, TX 78642-0037
(512) 778-5500
(512) 778-5500
Mailing address
PO BOX 37, 929 LOOP 332, LIBERTY HILL, TX 78642-0037
(512) 778-5500
(512) 778-5500

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC4366
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
601658
BLUE CROSS BLUE SHIELD #
TX
Enumeration date
01/18/2007
Last updated
04/03/2009
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