Provider Demographics
NPI:1861667511
Name:BUCHANAN, ROBERT W (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:BUCHANAN
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 1:1807 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79411-1827
Mailing Address - Country:US
Mailing Address - Phone:806-763-1479
Mailing Address - Fax:806-763-0826
Practice Address - Street 1:1807 34TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79411-1827
Practice Address - Country:US
Practice Address - Phone:806-763-1479
Practice Address - Fax:806-763-0826
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K1477OtherBLUE CROSS BLUE SHIELD
TX8F8835Medicare PIN