Provider Demographics
NPI:1548261233
Name:RIGGS, JOHN H III
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:RIGGS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 N GARFIELD ST STE B4
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2652
Mailing Address - Country:US
Mailing Address - Phone:432-570-8792
Mailing Address - Fax:432-686-3931
Practice Address - Street 1:4610 N GARFIELD B4
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-6614
Practice Address - Country:US
Practice Address - Phone:432-570-8792
Practice Address - Fax:432-686-3931
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1252447-05Medicaid
TXU54907Medicare UPIN
TX83044EMedicare ID - Type Unspecified