Provider Demographics
NPI:1669256038
Name:DAVID WALDROP LLC
Entity type:Organization
Organization Name:DAVID WALDROP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-564-9815
Mailing Address - Street 1:580 HIGHWAY 377 N
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-7450
Mailing Address - Country:US
Mailing Address - Phone:903-564-9815
Mailing Address - Fax:903-564-7891
Practice Address - Street 1:580 HIGHWAY 377 N
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-7450
Practice Address - Country:US
Practice Address - Phone:903-564-9815
Practice Address - Fax:903-564-7891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty