TERA EGLESTON CHIROPRACTIC CLINIC PC (NPI# 1508965252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508965252 |
| Entity Type | Organization |
| Organization Name | TERA EGLESTON CHIROPRACTIC CLINIC PC |
| Other Organization Name | TERA M EGLESTON DC |
| Practice Address |
9100 N Garnett Rd Suite I Owasso OK 74055 |
| Mailing Address |
Po Box 1161 Owasso OK 74055 |
| Practice Telephone | 9182742911 |
| Practice Fax Number | 9182742911 |
| Mailing Telephone | 9182742911 |
| Mailing Fax Number | 9182742911 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TERA MARCHELLE EGLESTON (DOCTOR OWNER) |
| Authorized Official Telephone | 9182742911 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3469 | OK | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | BCBS | 446821654002 | 01 |
| Other Name | Type Code |
|---|---|
| Tera M Egleston DC | Former Legal Business Name - Organization |
| Street Address |
9100 N GARNETT RD SUITE I |
| City | OWASSO |
| State | OK |
| Zip Code | 74055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669508529 | Tera Marchelle Egleston | Chiropractor | 9100 N Garnett Rd, Suite I., Owasso, OK 74055-4452 | 2007-02-26 |
| 1932250677 | Damon Loyd Smith | Veterinarian | 9100 N Garnett Rd, Suite E, Owasso, OK 74055-4452 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
| Find all providers in zip 74055 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265910681 | Lindsay Paige Lofton | Chiropractor | 505 E 19th St Ste 105, Owasso, OK 74055-4617 | 2018-07-30 |
| 1932577103 | Kyle Cavitt | Chiropractor | 11560 N 135th East Ave Ste 101a, Owasso, OK 74055-5756 | 2015-09-04 |
| 1568886240 | Nathan Traylor | Chiropractor | 8514 N 128th East Ave, Owasso, OK 74055-6242 | 2014-02-14 |
| 1326462466 | Warren Family Chiropractic Pllc | Chiropractor | 8361 N.owasso Expy, Suite E, Owasso, OK 74055-7805 | 2014-02-10 |
| 1417196981 | Scott Aldridge | Chiropractor | 12806 E 101st Pl N, Owasso, OK 74055-4662 | 2009-02-06 |
| 1437271558 | Justin Lee Ashlock | Chiropractor | 12899 E. 76th St. N., Ste. 101, Owasso, OK 74055 | 2007-04-06 |
| 1235268020 | Russell Dean Cox | Chiropractor | 8434 N 123rd East Ave, Owasso, OK 74055-2130 | 2007-03-05 |
| 1801959820 | Neil M Thomas | Chiropractor | 9500 N 129th East Ave, Ste 109, Owasso, OK 74055-5376 | 2006-12-19 |
| 1629137088 | Jason Eugene Drake | Chiropractor | 8283 N Owasso Expy, Suite B, Owasso, OK 74055-3634 | 2006-12-08 |
| 1487727970 | Daren L Kirk | Chiropractor | 12302 E 86th St N, Owasso, OK 74055-2543 | 2006-11-15 |
| Find all providers in OWASSO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.