Provider Demographics
NPI:1528369345
Name:TOPE, DALE WAYNE (LAC)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:WAYNE
Last Name:TOPE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15901 CENTRAL COMMERCE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2041
Mailing Address - Country:US
Mailing Address - Phone:512-494-4050
Mailing Address - Fax:512-494-4058
Practice Address - Street 1:15901 CENTRAL COMMERCE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2041
Practice Address - Country:US
Practice Address - Phone:512-494-4050
Practice Address - Fax:512-494-4058
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist