Provider Demographics
NPI:1467828988
Name:BROWN, CHARLES DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12900 PRESTON RD
Mailing Address - Street 2:SUITE 617
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1329
Mailing Address - Country:US
Mailing Address - Phone:972-789-9269
Mailing Address - Fax:972-789-9272
Practice Address - Street 1:12900 PRESTON RD
Practice Address - Street 2:SUITE 617
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1329
Practice Address - Country:US
Practice Address - Phone:972-789-9269
Practice Address - Fax:972-789-9272
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor