Provider Demographics
NPI:1639420607
Name:DANA MCKIRAHAN DC PA
Entity Type:Organization
Organization Name:DANA MCKIRAHAN DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:MCKIRAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-756-3747
Mailing Address - Street 1:1140 N FM 3083 RD W
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4566
Mailing Address - Country:US
Mailing Address - Phone:936-756-3747
Mailing Address - Fax:936-756-8906
Practice Address - Street 1:1140 N FM 3083 RD W
Practice Address - Street 2:SUITE 700
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4566
Practice Address - Country:US
Practice Address - Phone:936-756-3747
Practice Address - Fax:936-756-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU54621Medicare UPIN