Provider Demographics
NPI:1467550244
Name:KILLOUGH, DANNY R JR (CH)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:R
Last Name:KILLOUGH
Suffix:JR
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:DANNY
Other - Middle Name:R
Other - Last Name:KILLOUGH
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:106 N 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821
Mailing Address - Country:US
Mailing Address - Phone:325-365-8888
Mailing Address - Fax:325-365-2331
Practice Address - Street 1:106 N 7TH STREET
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821
Practice Address - Country:US
Practice Address - Phone:325-365-8888
Practice Address - Fax:325-365-2331
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD00263259OtherRAILROAD MEDICARE
TX8AD915OtherBLUE CROSS BLUE SHIELD
TX8AD915OtherBLUE CROSS BLUE SHIELD