Provider Demographics
NPI:1851482103
Name:CRANDALL, DON R (DC)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:R
Last Name:CRANDALL
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 1:3711 GARTH RD STE 140A
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3176
Mailing Address - Country:US
Mailing Address - Phone:832-926-4858
Mailing Address - Fax:832-926-4866
Practice Address - Street 1:3711 GARTH RD STE 140A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3176
Practice Address - Country:US
Practice Address - Phone:832-926-4858
Practice Address - Fax:832-926-4866
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5035OtherCHIROPRACTIC LICENSE