Provider Demographics
NPI:1417048588
Name:SUMMERS, LEE W (D C)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:W
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 BUFFALO GAP RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-7248
Mailing Address - Country:US
Mailing Address - Phone:325-695-0090
Mailing Address - Fax:325-695-0091
Practice Address - Street 1:4102 BUFFALO GAP RD
Practice Address - Street 2:SUITE A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-7248
Practice Address - Country:US
Practice Address - Phone:325-695-0090
Practice Address - Fax:325-695-0091
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088471001Medicaid
TX088471001Medicaid
TX605163Medicare ID - Type UnspecifiedMEDICARE