Provider Demographics
NPI:1225191075
Name:LIPTON VAN DE STEEG, CHERYL (DC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LIPTON VAN DE STEEG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:L
Other - Last Name:LIPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:325 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-3162
Mailing Address - Country:US
Mailing Address - Phone:254-933-2273
Mailing Address - Fax:254-933-2531
Practice Address - Street 1:325 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-3162
Practice Address - Country:US
Practice Address - Phone:254-933-2273
Practice Address - Fax:254-933-2531
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00277697OtherRR MEDICARE
TX8W5990OtherBLUE CROSS BLUE SHIELD
TXP00277697OtherRR MEDICARE