Provider Demographics
NPI:1740905389
Name:BEARD, CODY NEAL
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:NEAL
Last Name:BEARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 N FM 1417 STE R
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3109
Mailing Address - Country:US
Mailing Address - Phone:903-868-3808
Mailing Address - Fax:903-868-1432
Practice Address - Street 1:2121 N FM 1417 STE R
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3109
Practice Address - Country:US
Practice Address - Phone:903-868-3808
Practice Address - Fax:903-868-1432
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor