Provider Demographics
NPI:1861602641
Name:PROCTER, BARBARA J (DC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:PROCTER
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:3411 MARKET LOOP
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2773
Mailing Address - Country:US
Mailing Address - Phone:254-773-1121
Mailing Address - Fax:254-773-1185
Practice Address - Street 1:3411 MARKET LOOP
Practice Address - Street 2:SUITE 110
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2773
Practice Address - Country:US
Practice Address - Phone:254-773-1121
Practice Address - Fax:254-773-1185
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX8634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX653077Medicare PIN