Provider Demographics
NPI:1346284825
Name:WEST, DARRELL EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:EUGENE
Last Name:WEST
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 1:1600 S COULTER ST
Mailing Address - Street 2:BUILDING E, SUITE 701
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1710
Mailing Address - Country:US
Mailing Address - Phone:806-367-8480
Mailing Address - Fax:806-367-7789
Practice Address - Street 1:1600 S COULTER ST
Practice Address - Street 2:BUILDING E, SUITE 701
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-367-8480
Practice Address - Fax:806-367-7789
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13-4307663OtherTAX ID NUMBER
TX13-4307663OtherTAX ID NUMBER
TX8F2984Medicare ID - Type Unspecified