Healthcare Provider Details

I. General information

NPI: 1487705083
Provider Name (Legal Business Name): DOROTHY D. VACULA D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 SPICEWOOD SPRINGS RD BLDG. I STE. #2
AUSTIN TX
78759-8661
US

IV. Provider business mailing address

4131 SPICEWOOD SPRINGS RD BLDG. I STE. #2
AUSTIN TX
78759-8661
US

V. Phone/Fax

Practice location:
  • Phone: 512-524-8551
  • Fax: 512-524-8915
Mailing address:
  • Phone: 512-524-8551
  • Fax: 512-524-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: