Provider Demographics
NPI:1083616379
Name:CHATFIELD, RICHARD G (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:CHATFIELD
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 1:2803 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4812
Mailing Address - Country:US
Mailing Address - Phone:817-283-6100
Mailing Address - Fax:817-283-9536
Practice Address - Street 1:2803 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4812
Practice Address - Country:US
Practice Address - Phone:817-283-6100
Practice Address - Fax:817-283-9536
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601691Medicare ID - Type Unspecified
TXT12618Medicare UPIN