Provider Demographics
NPI:1780827865
Name:VINCENT, STEPHEN PIERCE (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PIERCE
Last Name:VINCENT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-1334
Mailing Address - Country:US
Mailing Address - Phone:806-335-0431
Mailing Address - Fax:
Practice Address - Street 1:8910 SW 34TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2065
Practice Address - Country:US
Practice Address - Phone:806-356-1362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor