Provider Demographics
NPI:1578278859
Name:ADAMS, MICHAEL QUE
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:QUE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 S EISENHOWER PKWY
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-7818
Mailing Address - Country:US
Mailing Address - Phone:903-465-1881
Mailing Address - Fax:903-463-4070
Practice Address - Street 1:1108 W WHITE ST STE 100
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-5638
Practice Address - Country:US
Practice Address - Phone:469-840-4111
Practice Address - Fax:469-840-4112
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UNKNOWNOtherUNKNOWN