Provider Demographics
NPI:1871662395
Name:PITTS, GEORGE CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CRAIG
Last Name:PITTS
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:PO BOX 2407
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-8507
Mailing Address - Country:US
Mailing Address - Phone:903-882-1828
Mailing Address - Fax:903-882-0804
Practice Address - Street 1:1437 S MAIN
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771
Practice Address - Country:US
Practice Address - Phone:903-882-1828
Practice Address - Fax:903-882-0804
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
10776965OtherCAQH
862225OtherBCBS
10776965OtherCAQH
U71695Medicare UPIN