Provider Demographics
NPI:1740453216
Name:MCCONNELL, MELVIN STAN (DC)
Entity type:Individual
Prefix:
First Name:MELVIN
Middle Name:STAN
Last Name:MCCONNELL
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 1:1803 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-3708
Mailing Address - Country:US
Mailing Address - Phone:972-259-4210
Mailing Address - Fax:
Practice Address - Street 1:1803 W 7TH ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-3708
Practice Address - Country:US
Practice Address - Phone:972-259-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor