Provider Demographics
NPI:1295842086
Name:CHANNING, RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:CHANNING
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 1:5850 TOWN AND COUNTRY BLVD
Mailing Address - Street 2:502
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6942
Mailing Address - Country:US
Mailing Address - Phone:972-731-6575
Mailing Address - Fax:214-975-1039
Practice Address - Street 1:7021 BELCREST DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7559
Practice Address - Country:US
Practice Address - Phone:972-731-6575
Practice Address - Fax:214-975-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605295OtherBC/BS PORVIDER NUMBER
TX611301Medicare ID - Type Unspecified
TX605295OtherBC/BS PORVIDER NUMBER