Provider Demographics
NPI:1316952724
Name:NOELL, KENT C (DC)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:C
Last Name:NOELL
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 1:1432 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-7002
Mailing Address - Country:US
Mailing Address - Phone:940-566-3232
Mailing Address - Fax:940-382-1604
Practice Address - Street 1:1432 UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7002
Practice Address - Country:US
Practice Address - Phone:940-566-3232
Practice Address - Fax:940-382-1604
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001064701Medicaid
TX8H5092OtherBLUE CROSS
TX3180646OtherCIGNA HMO
TX1316952724Medicare PIN
TXT15055Medicare UPIN