MR. CLYDE LAMAR LOGAN III (NPI# 1679789499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679789499 |
| Entity Type | Individual |
| Full Name | MR. CLYDE LAMAR LOGAN III |
| Credential | DC |
| Practice Address |
1001 N Beckley Ave Suite # 326-b Desoto TX 75115 |
| Practice Telephone | 9727099100 |
| Practice Fax Number | 9727093500 |
| Mailing Telephone | 9727099100 |
| Mailing Fax Number | 9727093500 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 8966 | TX | Chiropractic Providers |
| Street Address |
1001 N BECKLEY AVE SUITE # 326-B |
| City | DESOTO |
| State | TX |
| Zip Code | 75115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659587475 | Laura Ashley Padgett | Chiropractor | 1001 N Beckley Ave, Suite # 326-b, Desoto, TX 75115 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1407453384 | Heather Mcdowell | Massage Therapist | 100 Bob White St # 3, Desoto, TX 75115 | 2020-10-05 |
| 1295201580 | Daniel Max & Marcandrea, LLC | Optometrist | 1309 E. Pleasant Run Rd, Desoto, TX 75115 | 2018-10-15 |
| 1316432180 | Texas Home Health Group of De Soto, LLC | Home Health | 911 York Drive, Suite 203, De Soto, TX 75115 | 2018-06-25 |
| 1033606694 | Dental Health Associates of Texas, PC | Dentist | 1001 N Beckley, Desoto, TX 75115 | 2018-04-19 |
| 1023516093 | Joseph Chinaecherem Anya | Pharmacist | 805 Raintree Ln, Desoto, TX 75115 | 2018-01-25 |
| 1396253837 | Medical Care Innovation, P.C. | Clinic/Center | 2019 N Interstate 35 E, Desoto, TX 75115 | 2018-01-18 |
| 1124534888 | Herlonda Dotson | Counselor | 620 Candelila Drive, Desoto, TX 75115 | 2017-12-18 |
| 1053839548 | Floristene Johnson | Nutritionist | 1353 Armstrong Drive, Desoto, TX 75115 | 2017-09-05 |
| 1699290577 | Dlb Pharmacy LLC | Pharmacy | 1801 N Hampton, Suite 340, Desoto, TX 75115 | 2017-08-11 |
| Find all providers in zip 75115 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336601947 | Family Health & Spinal Rejuvenation Clinic LLC | Chiropractor | 1233 E Pleasant Run Rd Ste B, Desoto, TX 75115-4200 | 2019-04-02 |
| 1508352162 | Janair Osarollor | Chiropractor | 1301 E Parkerville Rd # B10, Desoto, TX 75115-6420 | 2018-07-06 |
| 1922501097 | Marcus L Waller | Chiropractor | 901 N Polk St Ste 349, Desoto, TX 75115-4014 | 2018-03-14 |
| 1033512470 | Dan Russel Mullaney | Chiropractor | 1607 Falcon Dr Ste 102, Desoto, TX 75115 | 2014-09-30 |
| 1245640903 | Shanna Scott | Chiropractor | 215 Dalton Dr Ste C4, Desoto, TX 75115-4454 | 2014-05-04 |
| 1467899005 | Michelle Renee Darden-jefferson | Chiropractor | 281 N I 35 E, Desoto, TX 75115-5299 | 2013-05-22 |
| 1275823072 | Cornell Cornish Sr. | Chiropractor | 1120 E Pleasant Run Rd, Suite 400, Desoto, TX 75115-7401 | 2011-04-13 |
| 1487877494 | Irc Diagnostics | Chiropractor | 900 N Polk St, #170, Desoto, TX 75115-4019 | 2007-04-10 |
| 1578619722 | Kathryn Elaine Barnes | Chiropractor | 1415 S Hampton Rd, Desoto, TX 75115-8097 | 2007-01-27 |
| 1528149002 | Neal Scott Hawkins | Chiropractor | 1801 N Hampton Rd Ste 490, Desoto, TX 75115-8308 | 2006-10-18 |
| Find all providers in DESOTO | ||||
Please comment or provide details below to improve the information on MR. CLYDE LAMAR LOGAN III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.