CMS-1500 Box 24J / 33a • NPI
1093952541
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
111N00000X (CMS 35)
Licensed & Credentialed Chiropractic Providers — Chiropractor
Box 32 Service Location & ZIP+4
1204 S 3RD ST, STE 102, MABANK, TX, 75147-7679
✓ 9-Digit EDI 837 ZIP+4 (75147-7679)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1093952541 (MABANK CHIROPRACTIC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1093952541 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | MABANK CHIROPRACTIC |
| Plain-English Specialty | Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: 111N00000X (Chiropractor) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1204 S 3RD ST, STE 102, MABANK, TX, 75147-7679 |
| Practice Telephone / Fax | Tel: (903) 887-6882 | Fax: (903) 887-3868 |
| Administrative Mailing Address | 1204 S 3RD ST, MABANK, TX, 75147-7679 |
| Enumeration & Last Sync | Enumerated: 2009-01-20 | CMS Record Updated: 2009-01-20 |
| Authorized Official | RICHARD HARRIS (Manager) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (111N00000X)
What Does Taxonomy Code 111N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MABANK CHIROPRACTIC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: TX | License: 8297 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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