Provider Demographics
NPI:1982447934
Name:EISCHEID, CODY (DC)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:EISCHEID
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 1:1900 HI LINE DR APT 423
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3371
Mailing Address - Country:US
Mailing Address - Phone:712-210-6359
Mailing Address - Fax:
Practice Address - Street 1:1900 HI LINE DR APT 423
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-3371
Practice Address - Country:US
Practice Address - Phone:712-210-6359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor