is a Chiropractor in Austin, Texas. practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for is 1104937028. The last update date is .
's current location address is 9609 Streamside Dr, Austin, Texas. You can contact this provider via phone number 5128922160 and fax number 5128927309. The mailing address for is 9609 Streamside Dr, Austin, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 9609 Streamside Dr, Austin, Texas |
| Phone Number | 5128922160 |
| Fax Number | 5128927309 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1104937028 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 9609 Streamside Dr |
|---|---|
| City | Austin |
| State | Texas (TX) |
| Post Code | 787362411 |
| Phone Number | 5128922160 |
| Fax Number | 5128927309 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 483 |
|
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6001179 | TX | BCBS | |
| 350005894 | TX | RAILROAD MEDICARE |
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