Provider Demographics
NPI:1891990818
Name:DARR, DARWIN LEE (DC)
Entity Type:Individual
Prefix:
First Name:DARWIN
Middle Name:LEE
Last Name:DARR
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 1:410 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-4908
Mailing Address - Country:US
Mailing Address - Phone:903-586-3667
Mailing Address - Fax:903-586-6404
Practice Address - Street 1:410 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-4908
Practice Address - Country:US
Practice Address - Phone:903-586-3667
Practice Address - Fax:903-586-6404
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088411601Medicaid
TX088411601Medicaid
TX603273Medicare PIN