Healthcare Provider Details

I. General information

NPI: 1174700579
Provider Name (Legal Business Name): ZYGMONT FAMILY CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 W SLAUGHTER LN STE. 470
AUSTIN TX
78749-6511
US

IV. Provider business mailing address

5900 W SLAUGHTER LN STE. 470
AUSTIN TX
78749-6511
US

V. Phone/Fax

Practice location:
  • Phone: 512-288-5502
  • Fax: 512-288-6529
Mailing address:
  • Phone: 512-288-5502
  • Fax: 512-288-6529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8017
License Number StateTX

VIII. Authorized Official

Name: DR. GREGORY DARIUS ZYGMONT
Title or Position: OWNER/DOCTOR
Credential: D.C.
Phone: 512-288-5502