Provider Demographics
NPI:1912105818
Name:OVERMILLER, DAREN JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAREN
Middle Name:JEAN
Last Name:OVERMILLER
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 1:3205 W CUTHBERT AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5595
Mailing Address - Country:US
Mailing Address - Phone:432-262-2440
Mailing Address - Fax:432-262-2442
Practice Address - Street 1:3205 W CUTHBERT AVE STE B2
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5595
Practice Address - Country:US
Practice Address - Phone:432-262-2440
Practice Address - Fax:432-262-2442
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor