Provider Demographics
NPI:1114333051
Name:ANCAR, KRISTIN PATRICE (DC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:PATRICE
Last Name:ANCAR
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 1:11601 LAGO VIS W
Mailing Address - Street 2:APT 1436
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6806
Mailing Address - Country:US
Mailing Address - Phone:504-450-2898
Mailing Address - Fax:
Practice Address - Street 1:5200 COLLEYVILLE BLVD
Practice Address - Street 2:B
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5865
Practice Address - Country:US
Practice Address - Phone:817-281-9040
Practice Address - Fax:817-281-4249
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor