Provider Demographics
NPI:1407105190
Name:STANTON, BRIAN S (DC, ACN)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:STANTON
Suffix:
Gender:M
Credentials:DC, ACN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18502 CAROUSEL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4261
Mailing Address - Country:US
Mailing Address - Phone:281-402-6528
Mailing Address - Fax:281-402-6538
Practice Address - Street 1:777 S FRY RD
Practice Address - Street 2:SUITE 206
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2244
Practice Address - Country:US
Practice Address - Phone:281-402-6528
Practice Address - Fax:281-402-6538
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9376111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition