Provider Demographics
NPI:1619029782
Name:STARK, ERIN MELISSA (DC, FICPA)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MELISSA
Last Name:STARK
Suffix:
Gender:F
Credentials:DC, FICPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6029 BELT LINE RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9109
Mailing Address - Country:US
Mailing Address - Phone:972-392-9402
Mailing Address - Fax:972-392-1903
Practice Address - Street 1:6029 BELT LINE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-9109
Practice Address - Country:US
Practice Address - Phone:972-392-9402
Practice Address - Fax:972-392-1903
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor