Provider Demographics
NPI:1780669929
Name:POTTS, DAVID A (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:POTTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4001 PRESTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2019
Mailing Address - Country:US
Mailing Address - Phone:281-249-2273
Mailing Address - Fax:281-249-2281
Practice Address - Street 1:4001 PRESTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-2069
Practice Address - Country:US
Practice Address - Phone:281-249-2273
Practice Address - Fax:281-249-2281
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2856Medicare PIN
TXU25147Medicare UPIN
TX8194K5Medicare ID - Type Unspecified