Provider Demographics
NPI:1629089032
Name:TRYLING, DAVID MARK (LAC, DAC,CH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:TRYLING
Suffix:
Gender:M
Credentials:LAC, DAC,CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 CENTRAL DR
Mailing Address - Street 2:SUITE 155
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6829
Mailing Address - Country:US
Mailing Address - Phone:817-835-0885
Mailing Address - Fax:817-571-1885
Practice Address - Street 1:2816 CENTRAL DR
Practice Address - Street 2:SUITE 155
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6829
Practice Address - Country:US
Practice Address - Phone:817-835-0885
Practice Address - Fax:817-571-1885
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00563171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist