Provider Demographics
NPI:1538642335
Name:NEWELL, GORDON WENDEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:WENDEL
Last Name:NEWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6417 FAIRCOVE CIR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-6100
Mailing Address - Country:US
Mailing Address - Phone:972-674-8684
Mailing Address - Fax:972-767-3389
Practice Address - Street 1:6417 FAIRCOVE CIR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-6100
Practice Address - Country:US
Practice Address - Phone:972-674-8684
Practice Address - Fax:972-767-3389
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13889111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation