Provider Demographics
NPI:1134575616
Name:BYARD, NATHAN ANDREW LAFAYETTE (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ANDREW LAFAYETTE
Last Name:BYARD
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 1:12377 MERIT DR STE 715
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2238
Mailing Address - Country:US
Mailing Address - Phone:469-317-3009
Mailing Address - Fax:844-675-9494
Practice Address - Street 1:12377 MERIT DR STE 715
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2238
Practice Address - Country:US
Practice Address - Phone:469-317-3009
Practice Address - Fax:844-675-9494
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor