Provider Demographics
NPI:1467944736
Name:PRIDDY, CALEB JORDAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:JORDAN
Last Name:PRIDDY
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 1:3121 CROSS TIMBERS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2718
Mailing Address - Country:US
Mailing Address - Phone:972-539-2323
Mailing Address - Fax:
Practice Address - Street 1:3121 CROSS TIMBERS RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2718
Practice Address - Country:US
Practice Address - Phone:972-539-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor