Provider Demographics
NPI:1922059401
Name:STARIN, WAYNE CHARLES (DC)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:CHARLES
Last Name:STARIN
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 1:1681 JUSTIN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4323
Mailing Address - Country:US
Mailing Address - Phone:972-420-0083
Mailing Address - Fax:972-539-2183
Practice Address - Street 1:1681 JUSTIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-4323
Practice Address - Country:US
Practice Address - Phone:972-420-0083
Practice Address - Fax:972-539-2183
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0573Medicare PIN
TX609075Medicare PIN