Healthcare Provider Details

I. General information

NPI: 1942440904
Provider Name (Legal Business Name): SASHA KECMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 US HIGHWAY 79 N
HENDERSON TX
75652-6013
US

IV. Provider business mailing address

1301 US HIGHWAY 79 N
HENDERSON TX
75652-6013
US

V. Phone/Fax

Practice location:
  • Phone: 903-657-6500
  • Fax: 903-657-4891
Mailing address:
  • Phone: 903-657-6500
  • Fax: 903-657-4891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number10338
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: