Provider Demographics
NPI:1285255828
Name:WORDEN, NATHANIEL ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:ALAN
Last Name:WORDEN
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 1:1450 HUGHES RD STE 250
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7364
Mailing Address - Country:US
Mailing Address - Phone:402-366-0246
Mailing Address - Fax:
Practice Address - Street 1:1450 HUGHES RD STE 250
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7364
Practice Address - Country:US
Practice Address - Phone:402-366-0246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor