Provider Demographics
NPI:1679623268
Name:FERGUSON, JAY W (DC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:W
Last Name:FERGUSON
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 1:4222 ROSEHILL RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-2503
Mailing Address - Country:US
Mailing Address - Phone:972-475-1562
Mailing Address - Fax:972-240-0565
Practice Address - Street 1:4222 ROSEHILL RD
Practice Address - Street 2:SUITE 7
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2503
Practice Address - Country:US
Practice Address - Phone:972-475-1562
Practice Address - Fax:972-240-0565
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor