Provider Demographics
NPI:1295703668
Name:THRASH, DAVID PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:THRASH
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 1:11025 ARBOR WOOD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-4425
Mailing Address - Country:US
Mailing Address - Phone:409-886-7246
Mailing Address - Fax:409-886-1219
Practice Address - Street 1:2315 N 16TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2329
Practice Address - Country:US
Practice Address - Phone:409-886-7246
Practice Address - Fax:409-886-1219
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10949111N00000X
AR1249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119222718Medicaid
AR119222718Medicaid
AR350048376Medicare PIN
ARU11320Medicare UPIN