Provider Demographics
NPI:1316979776
Name:COHOON, CHAD ALAN (DC)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:ALAN
Last Name:COHOON
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 1:6175 W MAIN ST
Mailing Address - Street 2:STE 299
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3441
Mailing Address - Country:US
Mailing Address - Phone:972-377-2273
Mailing Address - Fax:
Practice Address - Street 1:6175 W MAIN ST
Practice Address - Street 2:STE 299
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3441
Practice Address - Country:US
Practice Address - Phone:972-377-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104441111N00000X
TX11580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060964OtherBLUE CROSS BLUE SHIELD
TX060964Medicare PIN
KS060964OtherBLUE CROSS BLUE SHIELD