M BRANDON PETTKE DC PA NPI 1235319351

NPI Information

  • NPI: 1235319351
  • Provider Name: M BRANDON PETTKE DC PA
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • Doing Business As: HEALTHSOURCE CHIROPRACTIC & PROGRESSIVE REHAB
  • Address: 1320 NW JOHN JONES DR
    BURLESON, TX
    ZIP 76028
  • Phone: (817) 297-7100

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NPI Details

M BRANDON PETTKE DC PA is a chiropractor in Burleson, TX. The provider is 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. M BRANDON PETTKE DC PA NPI is 1235319351. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Healthsource Chiropractic & Progressive Rehab.

The provider's business location address is:

1320 NW JOHN JONES DR
BURLESON, TX
ZIP 76028-040
Phone: (817) 297-7100
Fax: (817) 297-7193

The provider's authorized official is Michael Brandon Pettke .
The authorized official title is President/owner and has the following contact phone number (817) 297-7100.

The enumeration date for this NPI number is 11/6/2007 and was last updated on 8/24/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor9711TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100037XOTHERTEXASMEDICARE GROUP
28C0840MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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