Provider Demographics
NPI:1114775939
Name:PATE, DYLAN (DC)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:PATE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 7TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-1200
Mailing Address - Country:US
Mailing Address - Phone:979-248-7412
Mailing Address - Fax:
Practice Address - Street 1:6500 7TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-1200
Practice Address - Country:US
Practice Address - Phone:979-248-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15937111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation