Provider Demographics
NPI:1609954858
Name:QUINLAN, JOHN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:QUINLAN
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 1:1600 NIAGARA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2450
Mailing Address - Country:US
Mailing Address - Phone:972-317-6706
Mailing Address - Fax:
Practice Address - Street 1:120 S DENTON TAP RD
Practice Address - Street 2:SUITE 410
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5036
Practice Address - Country:US
Practice Address - Phone:972-304-5900
Practice Address - Fax:972-304-6047
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU64743Medicare UPIN