Provider Demographics
NPI:1538964416
Name:BAGGETT, JOHNATHEN JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:JOHNATHEN
Middle Name:JOSEPH
Last Name:BAGGETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S SHILOH RD STE 107
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-8903
Mailing Address - Country:US
Mailing Address - Phone:972-840-2520
Mailing Address - Fax:972-840-2435
Practice Address - Street 1:1919 S SHILOH RD STE 107
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-8903
Practice Address - Country:US
Practice Address - Phone:972-840-2520
Practice Address - Fax:972-840-2435
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty