Provider Demographics
NPI:1306017496
Name:DAUDE, KEVIN WESLEY (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:WESLEY
Last Name:DAUDE
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 OAK CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7116
Mailing Address - Country:US
Mailing Address - Phone:832-385-6490
Mailing Address - Fax:
Practice Address - Street 1:7746 HIGHWAY 6 STE V
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4778
Practice Address - Country:US
Practice Address - Phone:832-904-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor