Provider Demographics
NPI:1538262415
Name:GREEN, FRANCES DAWN (DC)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:DAWN
Last Name:GREEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:D
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2500 WALNUT HILL LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5609
Mailing Address - Country:US
Mailing Address - Phone:972-438-6932
Mailing Address - Fax:214-902-3410
Practice Address - Street 1:111 S DELAWARE ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060-3031
Practice Address - Country:US
Practice Address - Phone:972-438-6932
Practice Address - Fax:214-902-3410
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU40386Medicare UPIN
TX88Z075Medicare ID - Type UnspecifiedGROUP MEDICARE #