Healthcare Provider Details

I. General information

NPI: 1912271933
Provider Name (Legal Business Name): OPTIMAL WC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 W WILLIAM CANNON DR STE 145
AUSTIN TX
78745-5000
US

IV. Provider business mailing address

3421 W WILLIAM CANNON DR STE 145
AUSTIN TX
78745
US

V. Phone/Fax

Practice location:
  • Phone: 512-358-0325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number11968
License Number StateTX

VIII. Authorized Official

Name: DR. JAMES STUBBS JR.
Title or Position: OWNER
Credential: DC
Phone: 512-358-0325