Provider Demographics
NPI:1235173360
Name:FLETCHER, WALKER LANDEN (DC)
Entity Type:Individual
Prefix:DR
First Name:WALKER
Middle Name:LANDEN
Last Name:FLETCHER
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 1:308 LAWN DR
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387-2341
Mailing Address - Country:US
Mailing Address - Phone:361-364-0775
Mailing Address - Fax:
Practice Address - Street 1:121 E SINTON ST
Practice Address - Street 2:
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387-2653
Practice Address - Country:US
Practice Address - Phone:361-364-0775
Practice Address - Fax:361-364-0768
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8813111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609722Medicare ID - Type Unspecified
TXU89575Medicare UPIN