Provider Demographics
NPI:1104203413
Name:MEYER, BETHANY ALISSA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:ALISSA MARIE
Last Name:MEYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6988 LEBANON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6743
Mailing Address - Country:US
Mailing Address - Phone:214-446-5300
Mailing Address - Fax:
Practice Address - Street 1:6988 LEBANON RD STE 101
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6743
Practice Address - Country:US
Practice Address - Phone:214-446-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6081111N00000X
TX13801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor