Provider Demographics
NPI:1205842135
Name:FLEISHMAN, DAN KEITH (DC,)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:KEITH
Last Name:FLEISHMAN
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 1:6150 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE K
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4000
Mailing Address - Country:US
Mailing Address - Phone:972-208-2070
Mailing Address - Fax:972-208-2070
Practice Address - Street 1:6150 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE K
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4000
Practice Address - Country:US
Practice Address - Phone:972-208-2070
Practice Address - Fax:972-208-2070
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor