Provider Demographics
NPI:1336389485
Name:SKAGGS, MARC T (DC)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:T
Last Name:SKAGGS
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 1:4111 FLAMINGO CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2584
Mailing Address - Country:US
Mailing Address - Phone:713-894-7678
Mailing Address - Fax:
Practice Address - Street 1:4111 FLAMINGO CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2584
Practice Address - Country:US
Practice Address - Phone:713-894-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor