Provider Demographics
NPI:1750271417
Name:KINDER, DALTON
Entity type:Individual
Prefix:
First Name:DALTON
Middle Name:
Last Name:KINDER
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 1:3155 STARS AND STRIPES WAY APT 214
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-1509
Mailing Address - Country:US
Mailing Address - Phone:512-965-9932
Mailing Address - Fax:
Practice Address - Street 1:1251 E SOUTHLAKE BLVD STE 351
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6479
Practice Address - Country:US
Practice Address - Phone:214-884-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor