Provider Demographics
NPI:1295158939
Name:PAEK, JOSH (DC)
Entity type:Individual
Prefix:DR
First Name:JOSH
Middle Name:
Last Name:PAEK
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 1:309 W DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINS
Mailing Address - State:TX
Mailing Address - Zip Code:75141-3024
Mailing Address - Country:US
Mailing Address - Phone:972-989-8547
Mailing Address - Fax:979-317-7707
Practice Address - Street 1:10611 GARLAND RD STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-4803
Practice Address - Country:US
Practice Address - Phone:972-989-8547
Practice Address - Fax:979-317-7707
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor