Provider Demographics
NPI:1700921905
Name:PATE, DARYL RAY (DC)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:RAY
Last Name:PATE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:6225 FEATHERWIND
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135
Mailing Address - Country:US
Mailing Address - Phone:817-721-6596
Mailing Address - Fax:972-938-0018
Practice Address - Street 1:2001 BATES
Practice Address - Street 2:#200 QUEST HEALTH & REHAB
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167
Practice Address - Country:US
Practice Address - Phone:972-938-7757
Practice Address - Fax:972-938-0018
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 6385111N00000X
TXMT016991225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V08412Medicare UPIN