Healthcare Provider Details
I. General information
NPI: 1619192085
Provider Name (Legal Business Name): NEBLETT ENTERPRISES, LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4029 S. CAPITAL OF TEXAS HWY. SUITE 100
AUSTIN TX
78704-7918
US
IV. Provider business mailing address
4029 S. CAPITAL OF TEXAS HWY. SUITE 100
AUSTIN TX
78704-7918
US
V. Phone/Fax
- Phone: 512-326-1400
- Fax: 512-326-1463
- Phone: 512-326-1400
- Fax: 512-326-1463
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 8163 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
DONALD
THOMAS
NEBLETT
JR.
Title or Position: PARTNER
Credential: D.C.
Phone: 51233261400