Provider Demographics
NPI:1033903745
Name:WALTON, JAILA NICOLE (DC)
Entity type:Individual
Prefix:
First Name:JAILA
Middle Name:NICOLE
Last Name:WALTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11107 W AIRPORT BLVD APT 2306
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3164
Mailing Address - Country:US
Mailing Address - Phone:424-309-3921
Mailing Address - Fax:
Practice Address - Street 1:27120 FULSHEAR BEND DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1190
Practice Address - Country:US
Practice Address - Phone:346-998-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor