Provider Demographics
NPI:1376547976
Name:MCKECHNIE, BRADEN ALAN SR (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADEN
Middle Name:ALAN
Last Name:MCKECHNIE
Suffix:SR
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 1:940 GEMINI ST
Mailing Address - Street 2:STE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2763
Mailing Address - Country:US
Mailing Address - Phone:281-486-1675
Mailing Address - Fax:281-486-1677
Practice Address - Street 1:940 GEMINI ST
Practice Address - Street 2:STE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2763
Practice Address - Country:US
Practice Address - Phone:281-486-1675
Practice Address - Fax:281-486-1677
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4268OtherCHIROPRACTIC LICENSE
TX608140OtherBLUE CROSS BLUE SHIELD
7604023OtherAETNA
2250419001OtherCIGNA
7604023OtherAETNA
2250419001OtherCIGNA