Provider Demographics
NPI:1346331162
Name:DILLON, BRIAN T (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:T
Last Name:DILLON
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 1:3900 PEBBLE CREEK CT
Mailing Address - Street 2:STE. 101
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5948
Mailing Address - Country:US
Mailing Address - Phone:972-612-4900
Mailing Address - Fax:972-612-3232
Practice Address - Street 1:3900 PEBBLE CREEK CT
Practice Address - Street 2:STE. 101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5948
Practice Address - Country:US
Practice Address - Phone:972-612-4900
Practice Address - Fax:972-612-3232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606100OtherBLUE CROSS
TX609440Medicare ID - Type Unspecified
TX606100OtherBLUE CROSS