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General NPI Number Information
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NPI Number | 1023199874
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Entity Type | Organization
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Legal Business Name | GOLD CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 101 E EXPRESSWAY 83 STE F
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City | PHARR
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State | TX
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Zip | 78577-6559
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Country | US
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Telephone | 956-782-8000
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Fax | 956-782-9000
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Provider Business Mailing Address
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Address Line | 101 E EXPRESSWAY 83 STE F
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City | PHARR
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State | TX
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Zip | 78577-6559
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Country | US
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Telephone | 956-782-8000
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Fax | 956-782-9000
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAVID WILLIAM COUTCHER
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Credential | D.C.
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Telephone | 956-782-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6283
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License Number State | TX
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