Provider Demographics
NPI:1730196544
Name:WOODARD, RONALD EUGENE (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EUGENE
Last Name:WOODARD
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2133 S GREAT SOUTHWEST PKWY
Mailing Address - Street 2:SUITE 505
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-7417
Mailing Address - Country:US
Mailing Address - Phone:972-647-2400
Mailing Address - Fax:
Practice Address - Street 1:2133 S GREAT SOUTHWEST PKWY
Practice Address - Street 2:SUITE 505
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-7417
Practice Address - Country:US
Practice Address - Phone:972-647-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89922081H0002X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine