Provider Demographics
NPI:1326125519
Name:LOUGHRIDGE, FLINT LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:FLINT
Middle Name:LEE
Last Name:LOUGHRIDGE
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 1:8200 STONEBROOK PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5539
Mailing Address - Country:US
Mailing Address - Phone:972-335-9733
Mailing Address - Fax:972-377-3723
Practice Address - Street 1:8200 STONEBROOK PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5539
Practice Address - Country:US
Practice Address - Phone:972-335-9733
Practice Address - Fax:972-377-3723
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2450OtherBLUE CROSS BLUE SHIELD
TX2174098OtherAETNA HMO
TX4412288OtherAETNA PPO
TX8334NOMedicare ID - Type Unspecified
TX8B2450OtherBLUE CROSS BLUE SHIELD