Provider Demographics
NPI:1447259312
Name:ADAMS, DAVID W (DC FICPA)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC FICPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101B WOODBINE PL
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-2912
Mailing Address - Country:US
Mailing Address - Phone:903-236-6222
Mailing Address - Fax:903-236-0808
Practice Address - Street 1:101B WOODBINE PL
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-2912
Practice Address - Country:US
Practice Address - Phone:903-236-6222
Practice Address - Fax:903-236-0808
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7964111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
609161Medicare PIN
TXU72472Medicare UPIN