Provider Demographics
NPI:1780896852
Name:SAPPINGTON, JOHN BRYAN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRYAN
Last Name:SAPPINGTON
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:PO BOX 2722
Mailing Address - Street 2:106 SIERRA GRANDE SUITE 100
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-2445
Mailing Address - Country:US
Mailing Address - Phone:972-617-5600
Mailing Address - Fax:972-617-5485
Practice Address - Street 1:106 SIERRA GRANDE
Practice Address - Street 2:SUITE 100
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2445
Practice Address - Country:US
Practice Address - Phone:972-617-5600
Practice Address - Fax:972-617-5485
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
608289OtherBLUE CROSS BLUE SHIELD
608289OtherBLUE CROSS BLUE SHIELD
610033Medicare ID - Type Unspecified