Healthcare Provider Details

I. General information

NPI: 1235270679
Provider Name (Legal Business Name): TROY CURTIS VAN BIEZEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BELT LINE RD STE 100
DALLAS TX
75254-6751
US

IV. Provider business mailing address

4950 BELT LINE RD STE 100
DALLAS TX
75254-6751
US

V. Phone/Fax

Practice location:
  • Phone: 972-239-0010
  • Fax:
Mailing address:
  • Phone: 972-239-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number7351
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: