Provider Demographics
NPI:1700895091
Name:CHICOINE, RICHARD VANCE (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:VANCE
Last Name:CHICOINE
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 1:6805 MAIN ST STE 410
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-1156
Mailing Address - Country:US
Mailing Address - Phone:972-625-6700
Mailing Address - Fax:972-370-6700
Practice Address - Street 1:6805 MAIN ST STE 410
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-1156
Practice Address - Country:US
Practice Address - Phone:972-625-6700
Practice Address - Fax:972-370-6700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4652TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2937Medicare ID - Type Unspecified