Provider Demographics
NPI:1396853982
Name:LARKS, KEVIN J (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:LARKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2225 WILLIAMS TRACE BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4440
Mailing Address - Country:US
Mailing Address - Phone:281-494-4444
Mailing Address - Fax:281-494-2117
Practice Address - Street 1:2225 WILLIAMS TRACE BLVD
Practice Address - Street 2:STE 102
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4440
Practice Address - Country:US
Practice Address - Phone:281-494-4444
Practice Address - Fax:281-494-2117
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 4351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605014Medicare ID - Type Unspecified