Patric Charles Fun, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14868 Issued in TX

Practice address

850 S Greenville Ave Ste 104
Richardson, TX 75081-5046

Phone

(972) 644-6336

Fax

(972) 644-7247

NPI assigned

Sep 21, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeclinic Chiropractic of Texas LLCGroup PAC ID 6002121027, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifeclinic Chiropractic of Texas, LLC

  • Chiropractor
  • Allen, TX
  • NPI 1417347899
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1861163834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S GREENVILLE AVE STE 104",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815046",
            "telephone_number": "972-644-6336",
            "fax_number": "972-644-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S GREENVILLE AVE STE 104",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750815046",
            "telephone_number": "972-644-6336",
            "fax_number": "972-644-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUN",
        "first_name": "PATRIC",
        "middle_name": "CHARLES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "14868",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patric@patricfun.com",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "850 S Greenville Ave Ste 104",
            "city": "Richardson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750815046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dayna L Fuchs, PH.D.
• Fulfilling Place
• Jonai Alisia Fullard
• Audrey Miriam Fuller, PA
• Candy Fuller
• Mallory Catherine Fusco, FNP-C
• G. Ray Hamby, D.D.S., M.S.D., Inc.
• Kenyon Owen Gaar, RD, LD
• Huda Gadid, FNP-BC
• Steven M Gadol, MD PA

• Chiropractor in Richardson, TX
• Providers in Richardson, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.