Provider Demographics
NPI:1538606108
Name:LETCHER, BEZAWIT (DC)
Entity type:Individual
Prefix:
First Name:BEZAWIT
Middle Name:
Last Name:LETCHER
Suffix:
Gender:F
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:PO BOX 551664
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75355-1664
Mailing Address - Country:US
Mailing Address - Phone:214-642-8518
Mailing Address - Fax:
Practice Address - Street 1:1221 ABRAMS RD STE 138
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5580
Practice Address - Country:US
Practice Address - Phone:214-642-8518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor