Provider Demographics
NPI:1023122504
Name:PRITCHETT, GARY L (DC)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:PRITCHETT
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 1:1313 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-2621
Mailing Address - Country:US
Mailing Address - Phone:254-582-8475
Mailing Address - Fax:254-582-7686
Practice Address - Street 1:1313 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2621
Practice Address - Country:US
Practice Address - Phone:254-582-8475
Practice Address - Fax:254-582-7686
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83670XOtherBLUE CROSS
TXU53799Medicare UPIN
TX8193J1Medicare ID - Type Unspecified