Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 10294 | TX |
NPI | 1265644181 |
---|---|
Provider Name | Dr. Christopher Michael Mcdougal |
First Address | Frisco, TX 75034-3838 |
Second Address | Irving, TX 75039-2875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 12/03/2010 |