Provider Demographics
NPI:1033137500
Name:IBARGUEN, KAREN LOUISE (DC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LOUISE
Last Name:IBARGUEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SWISHER RD
Mailing Address - Street 2:
Mailing Address - City:SHADY SHORES
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5714
Mailing Address - Country:US
Mailing Address - Phone:940-382-6000
Mailing Address - Fax:940-497-5484
Practice Address - Street 1:3610 N JOSEY LN # 1
Practice Address - Street 2:130
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-3100
Practice Address - Country:US
Practice Address - Phone:940-382-6000
Practice Address - Fax:940-497-5484
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8255111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU86656Medicare UPIN
TX609606Medicare ID - Type UnspecifiedBLUE CROSS MEDICARE NUMBE