Healthcare Provider Details

I. General information

NPI: 1871529255
Provider Name (Legal Business Name): DOUGLAS L BEMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 BRIDGE ST SUITE 500
FORT WORTH TX
76112-2384
US

IV. Provider business mailing address

5425 W SPRING CREEK PKWY SUITE 270
PLANO TX
75024-4236
US

V. Phone/Fax

Practice location:
  • Phone: 972-647-4175
  • Fax: 817-287-0001
Mailing address:
  • Phone: 972-647-4175
  • Fax: 817-287-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7931
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: