Provider Demographics
NPI:1942240452
Name:SHEPHERD, KARL ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:ANDREW
Last Name:SHEPHERD
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 1:6715 CRESTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5903
Mailing Address - Country:US
Mailing Address - Phone:972-733-3830
Mailing Address - Fax:
Practice Address - Street 1:1108 W PARKER RD
Practice Address - Street 2:#102
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4000
Practice Address - Country:US
Practice Address - Phone:972-333-6280
Practice Address - Fax:972-733-2988
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
103928OtherNATIONAL CERTIFICATION
103928OtherNATIONAL CERTIFICATION