Provider Demographics
NPI:1912148768
Name:WOODARD, DONALD RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:WOODARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1865 LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3479
Mailing Address - Country:US
Mailing Address - Phone:817-274-0351
Mailing Address - Fax:817-274-3466
Practice Address - Street 1:1190 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6367
Practice Address - Country:US
Practice Address - Phone:817-274-0351
Practice Address - Fax:817-274-3466
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-07
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor