Provider Demographics
NPI:1962879015
Name:GAUDET, SCHARLENE KAY (DC, DACNB)
Entity type:Individual
Prefix:DR
First Name:SCHARLENE
Middle Name:KAY
Last Name:GAUDET
Suffix:
Gender:F
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4742
Mailing Address - Country:US
Mailing Address - Phone:469-790-7343
Mailing Address - Fax:214-902-3428
Practice Address - Street 1:705 MAIN ST
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4742
Practice Address - Country:US
Practice Address - Phone:469-790-7343
Practice Address - Fax:972-304-6455
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1748111N00000X
TX12976111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor