Doug Pendergrass in Flora Vista - Chiropractor
Doug Pendergrass - NPI 1902942352
Doug Pendergrass is a Chiropractor in Flora Vista, New Mexico. Doug Pendergrass practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Doug Pendergrass is 1902942352. The last update date is 2015-12-30.
Doug Pendergrass's current location address is 12 Road 3540, Flora Vista, New Mexico. You can contact this provider via phone number 5058600862 and fax number 5058600862. The mailing address for Doug Pendergrass is 12 Road 3540, Flora Vista, New Mexico. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Doug Pendergrass |
|---|---|
| Address | 12 Road 3540, Flora Vista, New Mexico |
| Phone Number | 5058600862 |
| Fax Number | 5058600862 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1902942352 |
|---|---|
| Provider Enumeration Date | 2007-01-30 |
| Last Updated Date | 2015-12-30 |
Provider Mailing Address Detail
| Address | 12 Road 3540 |
|---|---|
| City | Flora Vista |
| State | New Mexico (NM) |
| Post Code | 874159601 |
| Phone Number | 5058600862 |
| Fax Number | 5058600862 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 1679 |
|
Definition: 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 inte |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8X8022 | TX | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to Doug Pendergrass by the Centers for Medicare & Medicaid Services (CMS)?
The Doug Pendergrass has been assigned the NPI (National Provider Identifier) 1902942352. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Doug Pendergrass's physical address?
The Doug Pendergrass is physically located at 12 Road 3540, in the city of Flora Vista, NM, with the postal code 874159601.
What is the Doug Pendergrass's area of specialization and corresponding taxonomy classification?
The Doug Pendergrass's specialty field is Chiropractor, and it falls under the taxonomy code 111N00000X, which categorizes healthcare providers based on their specialties.
On what date was the 1902942352 assigned to Doug Pendergrass?
The Doug Pendergrass was issued its 1902942352 on 2007-01-30, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Doug Pendergrass, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Doug Pendergrass, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-12-30.