Provider Demographics
NPI:1467908327
Name:BAEK, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:BAEK
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 1:8604 PRESTON RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3318
Mailing Address - Country:US
Mailing Address - Phone:469-351-7083
Mailing Address - Fax:844-639-7851
Practice Address - Street 1:8604 PRESTON RD
Practice Address - Street 2:SUITE 118
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3318
Practice Address - Country:US
Practice Address - Phone:469-351-7083
Practice Address - Fax:844-639-7851
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor