Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 11413 | TX |
N | 111N00000X | Chiropractor | 3209 | MA |
Y | 111NN1001X | Nutrition | 11413 | TX |
N | 111NN1001X | Nutrition | 3209 | MA |
N | 111NP0017X | Pediatric Chiropractor | 11413 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 3209 | MA |
NPI | 1770735763 |
---|---|
Provider Name | Dr. Elizabeth H Pilicy |
First Address | Addison, TX 75001-3950 |
Second Address | Addison, TX 75001-3950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 29/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11413 | TEXAS STATE CHIROPRACTIC LICENSE NUMBER (01) | TX |
3209 | MA STATE CHIROPRACTIC LICENSE NUMBER (01) | MA |