Provider Demographics
NPI:1821193152
Name:BREEDING, PAUL CAMDEN (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CAMDEN
Last Name:BREEDING
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 1:2620 CULLEN PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-9008
Mailing Address - Country:US
Mailing Address - Phone:281-412-0900
Mailing Address - Fax:281-412-4020
Practice Address - Street 1:2620 CULLEN PKWY STE 202
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-9008
Practice Address - Country:US
Practice Address - Phone:281-412-0900
Practice Address - Fax:281-412-4020
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601808Medicare ID - Type Unspecified
TXT12357Medicare UPIN