Provider Demographics
NPI:1518219344
Name:NEEDHAM, DAVID S (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:NEEDHAM
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 1:313 BASCOM RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3227
Mailing Address - Country:US
Mailing Address - Phone:903-714-7800
Mailing Address - Fax:
Practice Address - Street 1:1948 E HEBRON PKWY
Practice Address - Street 2:110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1525
Practice Address - Country:US
Practice Address - Phone:972-939-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor