Active NPI
Marisa Dawn Quevedo, DC
- Chiropractor
- Rowlett, TX
National Provider Identifier
1114736923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 16278
- Practice address
- 8405 Lakeview Pkwy Ste 202
Rowlett, TX 75088-4559 - Phone
- (972) 412-1150
- Fax
- (972) 412-1160
- NPI assigned
- Jan 6, 2025
- Last updated
- Jan 6, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 16278 | TX | Primary |
Addresses
Primary practice location
8405 Lakeview Pkwy Ste 202
Rowlett, TX 75088-4559
Mailing address
8405 Lakeview Pkwy Ste 202
Rowlett, TX 75088-4559
Phone (972) 412-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250131002992 | TX | Practitioner - Chiropractic | 5395274518 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16278 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1114736923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8405 LAKEVIEW PKWY STE 202",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884559",
"telephone_number": "972-412-1150",
"fax_number": "972-412-1160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8405 LAKEVIEW PKWY STE 202",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884559",
"telephone_number": "972-412-1150",
"fax_number": "972-412-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEVEDO",
"first_name": "MARISA",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-06",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "16278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.