Provider Demographics
NPI:1053483271
Name:BAUGHER, DAVID VINCE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VINCE
Last Name:BAUGHER
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 1:2500 LILLIAN MILLER PKWY
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-2902
Mailing Address - Country:US
Mailing Address - Phone:940-484-6336
Mailing Address - Fax:940-484-6335
Practice Address - Street 1:2500 LILLIAN MILLER PKWY
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-2902
Practice Address - Country:US
Practice Address - Phone:940-484-6336
Practice Address - Fax:940-484-6335
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02050501Medicaid
TX605878OtherBCBS
TX02050501Medicaid
TXTXB163406Medicare PIN
TX605878OtherBCBS