Provider Demographics
NPI:1750338299
Name:GROVES, LANCE E (DC)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:E
Last Name:GROVES
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 1:2120 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4187
Mailing Address - Country:US
Mailing Address - Phone:972-398-6600
Mailing Address - Fax:972-398-8001
Practice Address - Street 1:2120 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4187
Practice Address - Country:US
Practice Address - Phone:972-398-6600
Practice Address - Fax:972-398-8001
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609472Medicare ID - Type Unspecified
TXU83699Medicare UPIN