Provider Demographics
NPI:1679933246
Name:BYNUM, DAVID (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BYNUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4833 KELLER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-5912
Mailing Address - Country:US
Mailing Address - Phone:972-733-1014
Mailing Address - Fax:
Practice Address - Street 1:4833 KELLER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5912
Practice Address - Country:US
Practice Address - Phone:972-733-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor