Provider Demographics
NPI:1578009874
Name:CORGAN, CHANCE BRANDON (DC, MOT, OT)
Entity Type:Individual
Prefix:MR
First Name:CHANCE
Middle Name:BRANDON
Last Name:CORGAN
Suffix:
Gender:M
Credentials:DC, MOT, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4152 W SPRING CREEK PKWY STE 116
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5315
Mailing Address - Country:US
Mailing Address - Phone:972-964-7000
Mailing Address - Fax:972-964-7005
Practice Address - Street 1:4152 W SPRING CREEK PKWY STE 116
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5315
Practice Address - Country:US
Practice Address - Phone:972-964-7000
Practice Address - Fax:972-964-7005
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118040225X00000X
TX14748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist