Provider Demographics
NPI:1922091610
Name:CHASTEEN, DANIEL BEN (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BEN
Last Name:CHASTEEN
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 1:4203 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6006
Mailing Address - Country:US
Mailing Address - Phone:325-573-2913
Mailing Address - Fax:325-573-7035
Practice Address - Street 1:4203 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6006
Practice Address - Country:US
Practice Address - Phone:325-573-2913
Practice Address - Fax:325-573-7035
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001748501Medicaid
TX001748501Medicaid