Provider Demographics
NPI:1255565271
Name:DEEVERS, ROBERT BRENT (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRENT
Last Name:DEEVERS
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 1:625 PARKVIEW DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-4204
Mailing Address - Country:US
Mailing Address - Phone:682-831-1951
Mailing Address - Fax:682-292-2946
Practice Address - Street 1:625 PARKVIEW DR STE 103
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-4204
Practice Address - Country:US
Practice Address - Phone:682-831-1951
Practice Address - Fax:682-292-2946
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor