Provider Demographics
NPI:1720088115
Name:KINCHEN, GINGER (DC)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:
Last Name:KINCHEN
Suffix:
Gender:F
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:PO BOX 2407
Mailing Address - Street 2:
Mailing Address - City:BANDERA
Mailing Address - State:TX
Mailing Address - Zip Code:78003-2407
Mailing Address - Country:US
Mailing Address - Phone:830-339-2629
Mailing Address - Fax:
Practice Address - Street 1:6135 STATE HWY 173 N
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003
Practice Address - Country:US
Practice Address - Phone:830-339-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2020-08-05
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
TX6456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J0090OtherBCBS
TXU52662Medicare UPIN
TX8J0090OtherBCBS