Individual
KOMKRIT KAEWCHAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8501 N MACARTHUR BLVD, 0582 C/O CONSULTANT USA, IRVING, TX 75063-4100
(469) 442-7405
Mailing address
2668 N BELT LINE RD, IRVING, TX 75062-5245
(972) 513-6844
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
L3804
TX
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
L3804
TX
Other
Enumeration date
12/09/2013
Last updated
01/13/2015
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