Provider Demographics
NPI:1245233659
Name:DUVAL, WESLEY R (DC, DACBR)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:R
Last Name:DUVAL
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7109
Mailing Address - Country:US
Mailing Address - Phone:817-983-9955
Mailing Address - Fax:817-900-8656
Practice Address - Street 1:818 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7109
Practice Address - Country:US
Practice Address - Phone:817-983-9955
Practice Address - Fax:817-900-8656
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11228111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology