Provider Demographics
NPI:1841349750
Name:BAUGHER, DAVID CLARK (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLARK
Last Name:BAUGHER
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 1:314 S HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5746
Mailing Address - Country:US
Mailing Address - Phone:972-223-5055
Mailing Address - Fax:972-223-5353
Practice Address - Street 1:314 S HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5746
Practice Address - Country:US
Practice Address - Phone:972-223-5055
Practice Address - Fax:972-223-5353
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4574111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601858OtherBCBS PROV#
TX601858Medicare ID - Type UnspecifiedMEDICARE PROV#
TXDC4574Medicare UPIN