Provider Demographics
NPI:1164417911
Name:PHIPPS, DAVID E (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:PHIPPS
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 1:1200 E COLLINS BLVD
Mailing Address - Street 2:STE 108
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2417
Mailing Address - Country:US
Mailing Address - Phone:972-437-5800
Mailing Address - Fax:972-437-5850
Practice Address - Street 1:1200 E COLLINS BLVD
Practice Address - Street 2:STE 108
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2417
Practice Address - Country:US
Practice Address - Phone:972-437-5800
Practice Address - Fax:972-437-5850
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2017-01-31
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
TX4280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601651Medicare ID - Type Unspecified