Provider Demographics
NPI:1447206081
Name:KUCHENBACKER, KARL A (DC)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:A
Last Name:KUCHENBACKER
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 1:1108 BALLY MOTE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3904
Mailing Address - Country:US
Mailing Address - Phone:214-220-1217
Mailing Address - Fax:214-220-1196
Practice Address - Street 1:601 N AKARD ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3373
Practice Address - Country:US
Practice Address - Phone:214-220-1217
Practice Address - Fax:214-220-1196
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor