Provider Demographics
NPI:1811963911
Name:CORDER, KRISTI R (DC)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:R
Last Name:CORDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:KRISTI
Other - Middle Name:R
Other - Last Name:CYR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1828 MERCER WAY
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7735
Mailing Address - Country:US
Mailing Address - Phone:972-594-5015
Mailing Address - Fax:972-347-9534
Practice Address - Street 1:4324 N BELT LINE RD
Practice Address - Street 2:C-101
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3585
Practice Address - Country:US
Practice Address - Phone:972-594-5015
Practice Address - Fax:972-347-9534
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1791063-02Medicaid
TX19457OtherPARKLAND COMMUNITY HEALTH PLANS
TX608226OtherBCBS
TX10067177OtherAMERIGROUP
TX608226OtherBCBS
TX613457Medicare PIN