Provider Demographics
NPI:1548204704
Name:PEASE, DAVID M (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:PEASE
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 1:3115 W PARKER RD STE 390
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-8130
Mailing Address - Country:US
Mailing Address - Phone:972-897-1246
Mailing Address - Fax:
Practice Address - Street 1:3115 W PARKER RD STE 390
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-8130
Practice Address - Country:US
Practice Address - Phone:972-897-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155255602Medicaid
TX155255601Medicaid
TX00Z356Medicare PIN
TXU58124Medicare UPIN
TX155255602Medicaid
TX8A1238Medicare ID - Type Unspecified