Provider Demographics
NPI:1912025644
Name:DEVORE, JOHN M (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:DEVORE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2001 CENTRAL CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-8230
Mailing Address - Country:US
Mailing Address - Phone:972-548-3990
Mailing Address - Fax:972-548-3991
Practice Address - Street 1:4610 ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4434
Practice Address - Country:US
Practice Address - Phone:972-548-3990
Practice Address - Fax:972-548-3991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9063111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609811Medicare PIN