Provider Demographics
NPI:1033150560
Name:LOPER, DAVID W (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:LOPER
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 1:1911 N AUSTIN AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4543
Mailing Address - Country:US
Mailing Address - Phone:512-869-9811
Mailing Address - Fax:512-366-9902
Practice Address - Street 1:1911 N AUSTIN AVE STE 405
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4543
Practice Address - Country:US
Practice Address - Phone:512-869-9811
Practice Address - Fax:512-366-9902
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9896OtherMEDICARE PTAN
TX8AJ135OtherBLUE CROSS/BLUE SHIELD
TX8F9596Medicare UPIN
TX8F9896OtherMEDICARE PTAN