Provider Demographics
NPI:1770605743
Name:MACLENNAN, DAVID ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALEXANDER
Last Name:MACLENNAN
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 1:2009 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4339
Mailing Address - Country:US
Mailing Address - Phone:979-245-7374
Mailing Address - Fax:979-323-7460
Practice Address - Street 1:2009 13TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4339
Practice Address - Country:US
Practice Address - Phone:979-245-7374
Practice Address - Fax:979-323-7460
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W6020OtherBLUE CROSS BLUE SHIELD
TXU52297Medicare UPIN