Healthcare Provider Details
I. General information
NPI: 1902949001
Provider Name (Legal Business Name): DONALD MCKINLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/15/2007
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 W WILLIAM CANNON DR STE 704
AUSTIN TX
78745-5252
US
IV. Provider business mailing address
26865 INTERSTATE 45 STE 300
THE WOODLANDS TX
77380-4046
US
V. Phone/Fax
- Phone: 512-326-1400
- Fax:
- 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 | DC6885 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | DC6885 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: