Provider Demographics
NPI:1063803088
Name:DUNCAN, VANIECEA LATAE (DC)
Entity type:Individual
Prefix:
First Name:VANIECEA
Middle Name:LATAE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:VANIECEA
Other - Middle Name:LATAE
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 N TOWN EAST BLVD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4157
Mailing Address - Country:US
Mailing Address - Phone:972-279-7246
Mailing Address - Fax:972-279-0955
Practice Address - Street 1:1515 N TOWN EAST BLVD
Practice Address - Street 2:SUITE 135
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4157
Practice Address - Country:US
Practice Address - Phone:972-279-7246
Practice Address - Fax:972-279-0955
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor